生物衍生肌腱双侧关节突交叉固定动力重建颈椎后柱动态稳定性的体外生物力学研究  

BIOMECHANICAL ANALYSIS OF BILATERAL FACET JOINT STABILIZATION FOR POSTERIOR CERVICAL SPINE RECONSTRUCTION WITH BIO-DERIVED TENDON IN GOATS

作　　者：王贝宇[1] 刘浩[1] 侯伟光 解慧琪[3] 宋跃明[1] 洪瑛[4] 石锐[1] 马立泰[1] 

机构地区：[1]四川大学华西医院骨科,成都610041 [2]成都363医院骨科 [3]四川大学华西医院生物治疗国家重点实验室干细胞与组织工程研究室,成都610041 [4]四川大学华西医院手术室,成都610041

出　　处：《中国修复重建外科杂志》2012年第4期396-400,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：四川省科技厅科技支撑项目(2009SZ0170)~~

摘　　要：目的对于颈椎后柱不稳定进行动态稳定性重建研究鲜有报道。探讨采用冻干处理的生物衍生肌腱动力重建颈椎后柱动态稳定性的生物力学性能。方法收集死亡捐献者残肢掌长屈肌腱及掌伸肌腱制备生物衍生肌腱。20个新鲜成年山羊颈椎标本(C1～7),随机分为4组,每组5个标本。A组为完整标本组,B组为损伤模型组,C组为后柱钉棒固定组,D组为肌腱动力重建组。B、C、D组通过破坏颈椎后方韧带复合体制作屈曲分离型损伤模型,C组用侧块螺钉经后路固定,D组用生物衍生肌腱行侧块经关节突交叉固定。用脊柱三维运动测量系统测算各组标本C3、C4节段前屈、后伸、侧屈、旋转的运动范围(range of motion,ROM)。结果前屈运动:C组ROM明显小于其他3组,差异有统计学意义(P<0.05);B组ROM较A、D组明显增加,差异有统计学意义(P<0.05);A、D组间比较差异无统计学意义(P>0.05)。后伸、侧屈、旋转运动:C组ROM明显小于其他3组,差异有统计学意义(P<0.05);其他3组间比较差异无统计学意义(P>0.05)。结论新鲜成年山羊颈椎标本行生物衍生肌腱侧块经关节突交叉固定,能够限制颈椎过度前屈,完全保留后伸运动,不限制侧屈和旋转运动,重建屈曲分离型损伤下颈椎的动态稳定性。Objective There is few report on dynamic stabilization for posterior cervical reconstruction. To investigate the biomechanical properties of a novel cervical spine posterior fixation using the bio-derived freeze-dried tendon in posterior cervical spine reconstruction. Methods The palmaris longus flexor tendon and metacarpal extensor tendon were collected from the death donors＇ stump to prepare bio-derived tendon. Twenty fresh cervical vertebrae （C1-7） were harvested from goats and were randomly divided into 4 groups （n=5）： intact group （group A）; injury control group （group B）; screwrods fixation group, fixed with screw-rods on C3.4 （group C）; tendon reconstruction group, cross-fixed with bio-derived freezedried tendon on C3, 4 bilatera facet joints （group D）. The range of motion （ROM） values in flexion, extension, lateral bending, and axial rotation were measured. Results In flexion, the ROM values of group C were significantly lower than those of the other 3 groups （P 〈 0.05）, and the ROM values of group B were significantly higher than those of groups A and D （P 〈 0.05）. In extension, lateral bending, and axial rotation, the ROM values of group C were significantly lower than those of groups A, B, and D （P 〈 0.05）, and no significant difference was found within the other 3 groups （P 〉 0.05）. Conclusion The novel cervical spine posterior fixation using the bio-derived frozen-dried tendon can provide enough stability in flexion motion, but it can not limit the lateral bending and axial rotation motion, which can provide dynamic stabilization in animal model.

关 键 词：颈椎后方韧带复合体 生物力学 动态稳定性 生物衍生肌腱 

分 类 号：R687.3[医药卫生—骨科学]