纳米羟基磷灰石/聚酰胺66复合物椎间融合器在山羊颈椎融合中的应用  

Nano-hydroxyapatite and polyamide 66 complex intervertebral cage for anterior cervical fusion in goat

作　　者：陈日高[1] 屠重琪[1] 裴福兴[1] 段宏[1] 刘立岷[1] 宋跃明[1] 

机构地区：[1]四川大学华西医院脊柱外科,四川省成都市610041

出　　处：《中国脊柱脊髓杂志》2010年第4期286-290,共5页Chinese Journal of Spine and Spinal Cord

基　　金：国家科技支撑项目课题(编号:2007BAE131304)

摘　　要：目的:观察纳米羟基磷灰石/聚酰胺66复合物(n-HA/PA66)椎间融合器在山羊颈椎前路融合中的效果。方法:15只成年雌性山羊随机分成A、B、C组,每组5只,均行经前路C3/4椎间盘切除术,A组椎间置入n-HA/PA66椎间融合器植骨;B组置入钛网植骨;C组采用自体三面皮质髂骨块植骨。分别于术前、术后、术后4周、8周及12周拍X线片观察测量各组手术节段平均椎间高度(disc space height,DSH)、椎间角(intervertebral angle,IVA)及前凸角(lordosis angle,LA);12周时处死动物取颈椎标本进行生物力学测试及组织学检查。结果:术前三组DSH、IVA和LA无显著性差异。术后即刻及术后4周三组间DSH无显著性差异(P>0.05);术后8周及12周,A组DSH与B、C组有显著性差异(P<0.05);B组和C组差别无显著性(P>0.05)。术后即刻及术后4周、8周三组间IVA无显著性差异(P>0.05);术后12周,A、B组IVA与C组有显著性差异(P<0.05),A组与B组无显著性差异。术后即刻及术后4周、8周三组间LA差异无显著性(P>0.05);术后12周,A、B组LA与C组有显著性差异(P<0.05),B组与C组无显著性差异。术后12周时,A、B组颈椎标本各向角位移与C组有显著性差异(P<0.05);除后伸外A组各向稳定性优于B、C组;平均刚度均强于B、C组;ROM均小于B、C组(P<0.05)。A组在植骨区和椎间融合器边缘可见大量成熟的骨小梁组织,材料交界处可见大量纤维骨痂及新生骨形成,骨组织与材料表面已发生嵌合;B组的植骨块与椎体间的新生骨小梁已改建为成熟的骨小梁,部分区域尚可见未完全矿化的类骨质;C组可见较多的纤维骨痂形成,在骨小梁表面有红色的类骨质,部分区域有成熟的骨小梁。结论:n-HA/PA66椎间融合器能有效维持椎间隙高度,促进山羊颈椎前路植骨融合。Objective：To observe the efficacy of nano-hydroxyapatite and polyamide 66（n-HA/PA66） complex intervertebral cage for anterior cervical fusion in goat.Method：15 goats were randomly divided into group A,B and C（n=5）.C3/4 intervertebral disc resection was performed in all animals.Animals in group A underwent n-HA/PA66 intervertebral fusion cage,group B had titanium cage and group C had tricortex ilium bonygraft.The disc space height（DSH）,intervertebral angle（IVA） and lordosis angle（LA） at this segment were observed by X ray preoperatively,and postoperatively,and at 4 weeks,8 weeks and 12 weeks respectively.The C3/4 specimens were harvested at 12 weeks postoperatively to carry out biomechanical and histological test.Result：There was no significant difference with respect to DSH,IVA and LA among 3 gourps.There was no significant difference with respect to DSH among 3 groups postoperatively immediately and 4 weeks postoperatively（P〉0.05）.While at 8 and 12 weeks postoperatively,significant difference existed in group A and B,C with respect to DSH（P〈0.05）.There was no significant difference with respect to IVA among 3 groups postoperatively immediately,4 and 8 weeks postoperatively（P〉0.05）.At 12 weeks postoperatively,significant difference existed in group A,B and C with respect to the IVA（P〈0.05）.There was no significant difference with regard-ing to LA among 3 groups postoperatively immediately,4 and 8 weeks postoperatively（P〉0.05）.At 12 weeks postoperatively,significant difference existed in group A,B and C with respect to the LA,but no significant difference was noted between A and B.There were significant difference of angle translattion in group A and B compared with group C（P〈0.05）.Group A had better stiffness than group B and C,while ROM in group A was the contrary except in extension.There were amount of mature trabecula within graft site and around the cage in group A.While in group B,new born trabecula rebuilt as mature trabecula,but demineralized b

关 键 词：纳米羟基磷灰石/聚酰胺66复合物 椎间融合器 颈椎 融合术 山羊 

分 类 号：R318.08[医药卫生—生物医学工程] R687.3[医药卫生—基础医学]