腰椎前路可调式一体化钢板融合器的研制及生物力学测试  

Design and biomechanical test of the anterior adjustable lumbar intervertebral cage-plate complex instrument

作　　者：王良意[1] 周杰[1] 李红[1] 邢斐[1] 王以进[2] 

机构地区：[1]武警上海总队医院骨科,上海市201103 [2]上海科技大学生物力学实验室,上海市200082

出　　处：《中国脊柱脊髓杂志》2010年第4期277-280,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:研制腰椎前路可调式一体化钢板融合器(ALCP),并对其进行生物力学测试。方法:根据国人腰椎结构特点设计,应用医用钛合金材料制成ALCP。取15具6月龄猪腰椎标本,随机分成3组,每组5具,一组不行任何处理(对照组);两组行L3/4、L4/5椎间盘切除,并在L4椎体上开槽,一组用ALCP固定(ALCP组),另一组用前路钢板人工椎体固定(AVB组),测量每组标本在受到轴向压缩、前屈、后伸、侧屈及扭转状态下的载荷-位移、载荷-应变关系及强度和刚度的变化。结果:三组在轴向压缩、前屈、后伸和侧屈时腰椎的应变随载荷增大而增大,相同载荷下三组间应变无显著性差异(P>0.05);在500N以内载荷作用下,腰椎纵向压缩位移随载荷的增加而增加,三组间位移无显著性差异(P>0.05)。500N载荷轴向压缩时,ALCP组的应力强度最大(P<0.05),而在前屈、后伸及侧屈时三组间应力强度无统计学差异(P>0.05);三组间轴向刚度和弯曲刚度均无显著性差异(P>0.05)。ALCP组的最大扭矩为4.12N·m,AVB组为3.87N·m,对照组为4.18N·m,三组间无显著性差异(P>0.05)。ALCP组的扭转刚度与AVB组和对照组比较亦无显著性显差异(P>0.05)。结论:腰椎经ALCP固定后的生物力学性能接近人工椎体加前路钢板固定和正常腰椎。Objective：To design an anterior adjustable lumbar intervertebral cage-plate complex instrument（ALCP） and evaluate its biomechanical characteristics.Method：ALCP made of titanium alloy was designed according to the lumbar configuration of Chinese.Lumbar spine specimens from fifteen porcine of 6 month-old were randomly divided into three groups as follows,control group（C group）,ALCP group and artificial vertebral group together with anterior plate（AVB group）.The C group received no interference.A two-level discectomy（L3/4 and L4/5） was performed in two test group.After performing corpectomy at the level L4,test groups were subjected to either ALCP instrumentation or artificial vertebral body and anterior plate instrumentation.The load-displacement,load-strain,strength and stiffness in vertical compression,flexion-extension,lateral bending and torsion of each group were tested respectively.Result：The strain of each group increased with the raising of load under each orientation,while no significant difference was noted for strain of three groups under the same load（P〉0.05）.Under the load of less than 500N,the displacement of vertical compression increased with the raising of load,however no significant difference was noted between each group（P〉0.05）.Under the load of 500N,ALCP group showed greatest strength（P〉0.05）,while no statistical difference existed in flexion-extension and lateral bending（P〉0.05）.No statistical difference existed with respect to axial stiffness and bending stiffness.The maximum torque for ALCP group,AVB group and C group was 4.12N·m,3.87N·m and 4.18N·m,with no significant difference noted between three groups（P〉0.05）.The torque stiffness of ALCP group showed no difference with AVB group and C group（P〉0.05）.Conclusion：ALCP can provide the same biomechanical characteristics with AVB and normal lumbar spine.

关 键 词：脊柱 前路减压 内固定 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程] R318.1[医药卫生—基础医学]