异体腓骨环状腰椎间融合器的生物力学研究  

Biomechanical study of allogeneic fibula ring lumbar interbody fusion cage

作　　者：时伟峰 郭从涛[2] 周强[2] 

机构地区：[1]河南省南阳医学院第一附属医院医务科,河南南阳473058 [2]第三军医大学西南医院骨科,全军矫形外科中心,重庆400038

出　　处：《第三军医大学学报》2013年第12期1279-1283,共5页Journal of Third Military Medical University

摘　　要：目的评价异体腓骨环状椎间融合器行后路腰椎融合的生物力学稳定性。方法采用35具人体新鲜腰椎4、5节段标本,实验前通过影像学检查排除脊柱肿瘤、外伤、骨质疏松等情况,模拟后路经椎间孔植入椎间融合器。实验分7组:①正常组(Intact);②植入2枚钛合金解剖型融合器组(two titanium alloy anatomical fusion cage,Two,TAAFC);③植入2枚钛合金解剖型融合器结合后路椎弓根内固定组(two TAAFC and posterior pedicle screw system,Two TAAFC and PPSS);④植入2枚异体腓骨环状融合器组(two allogeneic fibula ring fusion cage,Two AFRFC);⑤植入2枚异体腓骨环状融合器结合后路椎弓根内固定组(Two AFRFC and PPSS);⑥植入3枚腓骨环状融合器组(Three AFRFC);⑦植入3枚异体腓骨环状融合器结合后路椎弓根内固定组(Three AFRFC and PPSS)。每组随机分5具标本,采用在脊柱三维运动试验机测试相同载荷下腰4/5节段在轴向压力、前屈、后伸、左右侧弯、旋转方向上的运动范围,并以抗轴向压力破坏试验,测试终板及2枚和3枚AFRFC的轴向压力力学极限。结果轴向压力试验:Two TAAFC and PPSS组与Two AFRFC and PPSS组有非常显著差异(P<0.01),与Three AFRFC and PPSS组无统计学差异(P>0.05),Two TAAFC组与Two AFRFC组有明显统计学差异(P<0.05),与Three AFRFC组无统计学差异(P>0.05);前屈试验:Two TAAFC组与Two AFRFC组有明显统计学差异(P<0.05),与Three AFRFC组无统计学差异(P>0.05);后伸试验、左、右侧弯试验和旋转试验:Two AFRFC and PPSS组与Two TAAFC and PPSS组和Three AFRFC and PPSS组均无统计学差异,Two AFRFC组与Two TAAFC组和Three AFRFC组也均无统计学差异(P>0.05)。压缩破坏试验表明:椎体终板的最大载荷为(13 649.50±942.06)N,单枚AFRFC最大轴向载荷(13 472.72±518.11)N,双枚AFRFC最大轴向载荷(22 658.33±554.92)N,3枚AFRFC最大载荷(25 384.50±687.64)N。结论椎间植入3枚或2枚AFRFC,结合椎弓根钉内固定均可使脊Objective To evaluate the biomechanical stability of allogeneic fibula ring lumbar inter- body fusion cage for posterior lumbar fusion. Methods Thirty-five fresh human lumbar spine specimens of seg- ment 4 and 5 were collected. Spinal tumors, trauma and osteoporosis were excluded by imaging examination before the experiment, and the implantation of lumbar interbody fusion through posterior intervertebral foramen was simulated. There were 7 experimental groups （n = 5） including： （1） normal group （complete specimen, in- tact） , （2） implantation of two titanium alloy anatomic fusion cages （ two titanium alloy anatomical fusion cages, two TAAFC） , （3） implantation of two titanium alloy anatomic fusion cages combined with posterior pedicle screw fixation （ two TAAFC and posterior pedicle screw system, two TAAFC and PPSS） , （4） implantation of two allo- geneic fibular ring fusion cages （two allogeneic fibula ring fusion cages, two AFRFC） , （5） implantation of two allogeneic fibular ring fusion cages combined with posterior pedicle screw fixation （two AFRFC and posterior pedicle screw system, two AFRFC and PPSS ） , （6） implantation of three allogeneic fibular ring fusion cages （three AFRFC ）, and （7） implantation of three allogeneic fibular ring cages combined with posterior pedicle screw fixation （three AFRFC and PPSS）. Spine three-dimensional motion testing machine was annlied to testthe movement range of lumbar segment 4/5 in the directions of axial pressure, flexion, extension, lateral ben- ding and rotation with the same load, and anti-axial pressure damage test was applied to examine the mechanical limits of the axial pressure of the end plate and two and three AFRFC. Results Axial pressure test： the two TAAFC and PPSS group was significantly different from the two AFRFC and PPSS group （P 〈 0.01 ）, but was not significantly different from the three AFRFC and PPSS group （P 〉 0.05）. The two TAAFC group was sig- nificantly different from the

关 键 词：异体腓骨 椎间融合器 腰椎 生物力学 

分 类 号：R197.39[医药卫生—卫生事业管理] R318.01[医药卫生—公共卫生与预防医学]