可注射骨诱导材料的椎间融合器研制及其Xtube管道下置入方法的研究  

Development of an injectable and bone-inducing cage for transforaminal lumbar interbody fusion under Xtube system and its anatomic study

作　　者：王建华[1] 夏虹[1] 尹庆水[1] 王善琛[1] 李树林[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》2010年第7期577-580,共4页Chinese Journal of Spine and Spinal Cord

基　　金：中国博士后基金资助项目(基金号20070410832)

摘　　要：目的:探讨一种可注射骨诱导材料的椎间融合器用于微创经椎间孔腰椎融合(TLIF)手术Xtube通道下置入的相关解剖学问题。方法:自行设计一种可注射骨诱导材料的新型椎间融合器,并通过解剖学测量确定其规格尺寸。应用40套成人腰骶椎干骨标本,针对不同椎间隙(L3/4、L4/5、L5/S1),分别测量斜跨中线放置时所需要的融合器理论长度及放置融合器的最佳倾斜角α;同时测量Xtube管道下操作允许的器械内倾角μ。结果:用于不同椎间隙时(L3/4、L4/5、L5/S1)融合器的理想倾角α分别是23.9°±3.8°(21.3°～28.2°)、25.8°±3.1°(22.2°～29.2°)和28.8°±3.8°(26.9°～33.6°)。相应倾斜角下,所需融合器的理论长度分别是28.7±4.4mm(26.8～31.2mm)、29.3±3.8mm(27.3～31.8mm)和30.4±4.6mm(28.6～30.8mm)。Xtube工作管道下操作允许的器械内倾斜角μ的均值为22.3°±2.5°(18.3°～27.5°)。结论:采用单枚融合器斜向放置的方法实施微创TLIF手术时,在L5/S1斜向对侧放置融合器时需要比L3/4、L4/5更大的内倾斜角,在实施L4/5、L5/S1椎间融合时,需要的融合器长度略长于L3/4间隙。Objective：To investigate relative anatomic issues of a new injectable and bone-inducing cage for miniamlly invasive transforaminal interbody fusion.Method：A minimally invasive cage together with injectable artificial bone was developed for TLIF,its size was determined by anatomic measurements.40 Chinese human cadver lumbar specimens were used to measure the idea length of cage placed obliquely as well as the ideal oblique angle（α） across middle-line at L3/4、L4/5 and L5/S1 respectively,and the introversion angle for instrument placement under the Xtube system（μ） were recorded either.Result：The α angle was 23.9°±3.8°（21.3°-28.2°）,25.8°±3.1°（22.2°-29.2°） and 28.8°±3.8°（26.9°-33.6°） respectively for L3/4,L4/5 and L5/S1.The ideal lengths for the cages under correspondence α angle was 28.7±4.4mm（26.8-31.2mm）,29.3±3.8mm（27.331.8mm） and 30.4±4.6mm（28.6-30.8mm） for L3/4,L4/5 and L5/S1 respectively.The μ angle for Xtubes was 22.3°±2.5°（18.3°-27.5°）.Conclusion：When performing minimaly invasive transforminal interbody fusion using single cage,larger introversion angle in L5/S1 than in L3/4 and L4/5 is recommended,and theoretically larger the length of cage in L4/5 and L5/S1 is larger than in L3/4.

关 键 词：Xtube 椎间融合器 可注射人工骨 经椎间孔融合术(TLIF) 

分 类 号：R681.5[医药卫生—骨科学] R318.08[医药卫生—外科学]