聚DL-乳酸椎间融合器植入山羊颈椎初始生物力学稳定性作用的研究  

Study of the Immediate Biomechanical Stability in a Goat Cervical Spine Model

作　　者：李晓辉[1,2] 周春光[1] 宋跃明[1] 

机构地区：[1]四川大学华西医院骨科,成都610041 [2]天津医院,天津300211

出　　处：《生物医学工程学杂志》2009年第5期1000-1004,共5页Journal of Biomedical Engineering

摘　　要：设计制备新型聚DL-乳酸椎间融合器(Poly-DL-lactic acid Cage,PDLLA Cage),探讨其对山羊颈椎C3-4融合术后的初始生物力学稳定作用。将27只山羊颈椎标本随机分为4组:正常对照组,PDLLACage组,钛合金Cage组,自体三面皮质髂骨组,切除颈3/4椎间盘后植入以上内植物,预载荷20N,采用1～4Nm逐级加载纯力矩的方法进行前屈、后伸、侧屈和旋转的生物力学测定,由此计算出各组活动范围(Range of motion,ROM)及平均刚度,并行比较。在ROM方面,后伸和旋转加载时,PDLLA Cage组与钛合金Cage组无显著性差别(P>0.05),与正常对照组、自体髂骨组有显著性差别(P<0.05);前屈加载时,各组间均有显著性差别(P<0.05);侧屈加载时,PDLLA Cage组与自体髂骨组无显著差别(P>0.05),余组间差异均有显著性(P<0.05)。植入Cage后颈椎刚度显著增大,前屈和旋转加载时,PDLLA Cage组与正常对照组、自体髂骨组均有显著差异(P<0.05)。结论:PDLLA Cage可为山羊颈椎椎间融合提供足够的初始生物力学稳定性。A new kind of Cage made of poly-DL-lactic acid was designed and an in-vitro study was conducted to evaluate the biomechanical effect of PDLLA Cage on a goat cervical spine model. 27 goat cervical spines were divided into four groups randomly： intact group, PDLLA Cage group, titanium Cage group, and autologous tricortieal iliae crest bone group. Different implants were implanted after complete discectomy （C3-4） was performed, then they were tested in flexion, extension, axial rotation, and lateral bending with a nondestructive stiffness method using a nonconstrained testing apparatus, and three-dimensional displacement was measured. The range of motion （ROM） and the mean stiffness values were calculated and compared between groups. The result showed that the ROM values between PDLLA Cage group and the titanium Cage group were not significantly different in extensional and rotational movement （P〉0.05）, but they were lower than that of rest groups （P〈0.05）. In flexional loading mode, the ROM values showed statistically significant difference between the four groups （P〈0.05）. And in lateral bending loading mode, no significant difference was found between PDLLA Cage group and iliac crest bone group（P〉0.05）, but significant differenee was found among the other groups（P〈0.05）. The stiffness of cervical spine was raised after Cage was implanted. In flexional and rotational loading mode, significant difference in stiffness was found between PDLLA Cage group and control group or iliae crest bone group（P〈0. 05）. So PDLLA Cage can provide enough primary stability for cervical intervertebral fusion.

关 键 词：山羊颈椎 生物力学 椎间融合器 体外研究 

分 类 号：R687.3[医药卫生—骨科学] R318.01[医药卫生—外科学]