记忆合金U形钉固定对山羊脊柱侧凸椎体的矫形度  

The vertebral correction angles of goat scoliosis by shape memory alloy staple

作　　者：宋迪煜[1] 张永刚[1] 孟传龙[1] 郑国权[1] 白林[1] 张巍[1] 张如意[1] 李涛[1] 

机构地区：[1]解放军总医院骨科,北京市100853

出　　处：《中国脊柱脊髓杂志》2009年第8期618-622,共5页Chinese Journal of Spine and Spinal Cord

基　　金：科技部"863"专题课题(编号:2006AA02Z4D6)

摘　　要：目的:观察记忆合金U形钉固定对侧凸山羊的椎体矫形度,探讨记忆合金U形钉固定对侧凸脊柱椎体生长调节的可行性。方法:用单侧椎弓根钉不对称拴系的方法建立雌性幼年山羊侧凸模型。建模8～10周后山羊进展为明显的脊柱侧凸,将动物随机分为对照组和治疗组,两组山羊均取出后路拴系物,治疗组取出栓系后凸侧行前路记忆合金U形钉固定术,对照组不作处理。继续观察8～13周,定期摄X线片,记录Cobb角。处死前第18天和第3天分别给予土霉素和钙黄绿素以标记生长板的骨化前缘。处死动物后完整获取顶椎上椎间盘以及两相邻的生长板,聚甲基丙烯酸甲酯包埋,不脱钙切片;荧光显微镜下测量两荧光标记线之间的距离,分别计算椎体两侧生长板的生长率,并根据生长率差异计算记忆合金U形钉对椎体的矫形度数。结果:在治疗期内,治疗组Cobb角矫正19.2°±8.1°,与治疗前比较有显著性差异(P<0.05);对照组Cobb角无明显变化(P>0.05)。治疗组凹侧生长板生长率为(3.27±0.96)μm/d,明显大于凸侧记忆合金U形钉置入侧(1.84±0.52)μm/d(P<0.05);对照组凹侧生长率为(2.83±0.61)μm/d,凸侧为(2.96±0.77)μm/d,两侧差异无统计学意义(P>0.05)。记忆合金U形钉对顶椎的椎体矫形度平均为0.017°±0.006°/d,同主弯整体矫形度之间存在明显的直线相关性(R2=0.941,P=0.006),其在整体矫形中占13.18%。结论:记忆合金U形钉固定能够对椎体产生有效的椎体矫正角度,以达到对侧凸脊柱椎体生长调节的目的。Objective：To observe the vertebral correction angle of goat scoliosis by shape memory alloy staple and further investigate the feasibility of growth control of scoliosis with shape memory alloy staples. Method：Experimental scoliosis was made in juvenile female goats using unilateral pedicle screws asymmetric tethering technique.After a period of 8-10 weeks of the tethering,9 goats developed seoliotic curves of significant magnitude and were divided randomly into treated group（n=5） and control group（n=4）.All tethers were removed in both groups,then treated group underwent anterior vertebral stapling with shape memory alloy staples and nothing to do for the control group.All goats were observed for an additional 8-13 weeks and serial radiographs were taken to document Cobb angles.The fluorochromes oxytetracycline and calcein were administered to the goats respectively 18 and 3 days prior to sacrifice in order to label the ossifying anterior border of the growth plates.Superior intervertebral disc of apical vertebrae and two adjacent growth plates were completely harvested in all goats after sacrifice.All specimens were embedded with polymethyl methacrylate（PMMA） and sliced in undecalcified form.Growth rate of the vertebral growth plates was calculated by measuring the distance between the two fluorescent lines under fluorescence microscope,and then the correction angles of stapled vertebrae were estimated according to the difference of growth rates between two sides.Result：Dnring the treatment period,treated group had a correction of 19.2°±8.1° with significant difference compared to the angles prior to the treatment （P〈0.05）,whereas Cobb angles in control group had almost no change （P〉 0.05）.In treated group,the growth rate of growth plate in the concave side was 3.27±0.96μm per day,which was higher than that in convex stapled side （1.84±0.52μm per day）（P〈0.05）,while the growth rate of the concavity did not show any significantly difference from that of the convexity

关 键 词：脊柱侧凸 记忆合金U形钉 侧凸矫形 生长板 荧光素标记 

分 类 号：R687.3[医药卫生—骨科学] R682.3[医药卫生—外科学]