微创椎间融合器的设计及其置入的解剖学研究  

The development of a minimally invasive cage and the related anatomic study of it's implantation

作　　者：王建华[1] 尹庆水[1] 夏虹[1] 吴增晖[1] 王善琛[1] 刘启宇[1] 赖震[1] 

机构地区：[1]广州军区广州总医院骨科,广州市510010

出　　处：《中国脊柱脊髓杂志》2008年第9期669-672,共4页Chinese Journal of Spine and Spinal Cord

基　　金：广州市科技计划基金项目(编号:2004Z3-E0211)

摘　　要：目的:探讨椎间盘内窥镜下置入自行设计的下腰椎微创椎间融合器的可行性。方法:自行设计的下腰椎椎间融合器宽度女性为7mm,男性为8mm。72具年龄32～66岁的成人腰骶椎干骨标本,将L4、L5和S1的上关节突由内向外分作3等份后分别测量上关节突内缘点及另外2个等份点与脊椎中线的距离,获得保留小关节与小关节切除1/3及2/3后的骨窗宽度。结果:保留小关节时,L3/4、L4/5、L5/S1的骨窗宽度男性分别为7.2±1.7mm、8.8±1.7mm、10.6±2.2mm,其中>8mm者分别占83.3%、88.9%、94.4%,女性分别为6.1±1.7mm、7.5±1.7mm、9.7±2.4mm,其中>7mm者分别占75.0%、88.9%、91.7%;将小关节切除1/3后,男性骨窗宽度分别为9.3±1.5mm、11.8±1.5mm、13.1±2.1mm,其中>8mm者分别占91.7%、100%、100%,女性分别为8.2±1.3mm、10.7±1.7mm、12.1±2.3mm,其中>7mm者分别占88.9%、100%、100%;小关节切除2/3后,男性骨窗宽度分别为11.8±2.1mm、14.1±2.4mm、16.1±3.3mm,均>8mm,女性分别为10.7±2.2mm、13.2±2.1mm、15.2±3.5mm,均>7mm。结论:新设计的融合器可以通过内窥镜工作管道,理论上可在椎板小开窗条件下置入L4/5、L5/S1椎间隙。Objective：To investigate the feasibility of implantation of the new designed minimally invasive cage through the microendscopy discectomy （MED） working tube.Method：A minimally invasive cage with width of 8ram for man and 7mm for woman was developed.72 veterbral specimens of Chinese human dry cadaver bones aged 32-66 years old were studied as follows.The upper facet of IA,L5 and S1 was derided into 3 equal parts,then the following parameters were measured respectively in order to obtain the data of lamina window width when the whole facet was preserved,1/3 or 2/3 of the facet was removed.They were distance from the inner rim of the upper facet to the middle line of the vertebrae,distance from the inner 1/3 divided point to the middle line of the vertebrae ,distance from the inner 2/3 divided point to the middle line of the vertebrae.Result：When the lamina window was performed without facetectomy,the width of lamina window for L3/4,L4/5,L5/S1 in man was 7.2±1.7mm,8.8±1.7mm,10.6±2.2mm respectively,among which the size over 8mm accounted for 83.3%,88.9%,94.4%,and in woman was 6.1±1.7mm,7.5±1.7mm,9.7±2.4mm respectively, the size over 7mm accounted for 75.0%,88.9%,91.7%.When inner 1/3 of the facets was resected,the lamina window width for L3/4,L4/5,L5/S1 was 9.3±1.5mm,11.8±1.5mm,13.1±2.1mm in man （the size over 8mm accounted for 91.7%,100%,100% respectively）;and 8.2±1.3mm,10.7mm, 12.1±2.3mm in woman （the size over 7mm accounter for 88.9%,100%,100%） respectively.When inner 2/3 of the facets was resected,the lamina window width for L3/4,L4/5,L5/S1 was 11.8±2.1mm, 14.1±2.4mm, 16.1±3.3mm in man（all greater than 8mm）, and 10.7±2.2mm,13.2±2.1mm,15.2±3.5mm in women （all greater than 7mm）.Conclusion：The newly desinged cage could be placed into the intervertebral space of L4/5 or L5/S1 through the MED working tube without facetectomy or with less than 1/3 facetectomy.

关 键 词：椎间融合器 腰椎 解剖学测量 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R318.1[医药卫生—基础医学]