可吸收椎体内支撑器的研制及植入途径研究  

Development of centrum-vertebra-fracture-repairing absorbable supporting plugger and the study of its implantation pathway

作　　者：张欲燃[1] 汤逊[2] 熊成东[3] 张茂枢[2] 徐永清[2] 周田华[2] 刘力[2] 

机构地区：[1]河南省濮阳市中医院,河南濮阳457000 [2]中国人民解放军成都军区昆明总医院,云南昆明650032 [3]中国科学院成都有机化学研究所,四川成都610041

出　　处：《中医正骨》2011年第7期20-24,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:研制用于胸腰椎骨折椎体重建的可吸收椎体内支撑器,并探讨经椎弓根植入的可行性。方法:选择100例健康成年志愿者,CT扫描其T11~L4椎骨,模拟重建T11~L4椎骨的二维、三维图像,测量椎体矢状径、横径和椎弓根内径高度、宽度。据此确定可植入支撑器的规格,并以聚-DL-乳酸(分子量40~80万)、磷酸三钙或羟基磷灰石为原料制成成品试件。将成品试件经椎弓根植入3具成人尸体标本的L1、L2椎体中,完成后摄腰椎标本正侧位X线片,并行L1、L2椎骨CT扫描、矢状面二维重建。结果:T11~L4椎体横径(32.44±2.82)^(42.13±4.10)mm,椎体矢状径(25.55±2.54)^(28.97±2.24)mm;T11~L4椎弓根内径高度(9.16±1.40)^(12.46±1.67)mm,椎弓根内径宽度(5.78±0.89)^(8.88±1.51)mm,椎弓根内径高度及宽度两侧相比,差异无统计学意义(T11~L4椎弓根内径高度:t=1.857,P=0.334;t=1.673,P=0.707;t=2.355,P=0.685;t=1.983,P=0.126;t=2.435,P=0.148;t=2.871,P=0.774。T11~L4椎弓根内径宽度:t=0.134,P=0937;t=1.962,P=0.125;t=0.453,P=0.634;t=1.983,P=0.509;t=1.643,P=0.086;t=0.851,P=0.150)。②设计的系列可吸收椎体内支撑器规格为:长20.0~27.0 mm,宽7.0~10.0 mm,高9.0~12.0 mm。③经X线及CT检查,经椎弓根植入3具成人尸体标本L1、L2椎体中的可吸收椎体内支撑器位置良好。结论:可吸收椎体内支撑器经椎弓根或经椎弓根及其外侧壁植入重建胸腰椎前中柱是可行的。Objective：To develop the centrum-vertebra-fracture-repairing absorbable supporting plugger（CASP）used for the vertebral reconstruction after the thoracolumbar fractures,and to explore the feasibility of CASP＇s implantation via the pedicle of vertebral arch.Methods：One hundred healthy adult volunteers were chosen to reconstruct the 2D and 3D images of T11-L4 vertebras through CT scanning their T11-L4 vertebras,then the vertebral sagittal diameters,the vertebral transverse diameters,heights and widths of pedicle of vertebral arch were measured from above images.After that,the specifications of the implantable supporting pluggers were determined according to above measurements,and the finished product were manufactured from the following 3 materials as poly-DL-lacti acid（molecular weights ranged from 400,000 to 800,000）,tricalcium phosphate and hydroxyapatite.The finished product were implanted into L1 vertebra and L2 vertebra of 3 adult cadavers via their pedicles of vertebral arch respectively.Next,PALAT X-ray films of the lumbar of cadavers were taken and conserved,L1 vertebra and L2 vertebra were scanned by CT and the image of their sagittal planes were processed with two-dimensional reconstruction.Results：①The transverse diameters of T11-L4 vertebras ranged from（32.44±2.82）mm to（42.13±4.10）mm,and their sagittal diameters ranged from（25.55±2.54）mm to（28.97±2.24）mm;the inner heights of pedicle of vertebral arch ranged from（9.16±1.40）mm to（12.46±1.67）mm,and their inner widths ranged from（5.78±0.89）mm to（8.88±1.51）mm,and there was no statistical difference in the inner heights and inner widths between the both sides of the pedicles of vertebral arch（Inner heights：t=1.857,P=0.334;t=1.673,P=0.707;t=2.355,P=0.685;t=1.983,P=0.126;t=2.435,P=0.148;t=2.871,P=0.774.Inner widths：t=0.134,P=0937;t=1.962,P=0.125;t=0.453,P=0.634;t=1.983,P=0.509;t=1.643,P=0.086;t=0.851,P=0.150）.②The specifications of the designed CASP series were as follows：the lengths ranged f

关 键 词：脊柱骨折 椎体成形术 可吸收椎体内支撑器 

分 类 号：R687.3[医药卫生—骨科学]