新型颈椎后路椎管成形桥接融合器三维运动力学及稳定性测试  

Biomechanical properties of a novel cervical posterior lumbar bridging fusion cage for posterior cervical single open-door laminoplasty

作　　者：李浩曦 刘涛 周军 巴兆玉[1] 刘晓明 芮永 吴德升[1] Hao-xi;LIU Tao;ZHOU Jun;BA Zhao-yu;LIU Xiao-ming;RUI Yong;WU De-sheng(Department of Spinal Surgery,Dongfang Hospital,Tongji University,Shanghai 200120,China)

机构地区：[1]同济大学附属东方医院脊柱外科,上海200120 [2]上海市虹口区江湾医院骨科,上海200120 [3]第二军医大学附属浦东公利医院骨科,上海200120 [4]中国创生医疗集团工程技术研发中心,江苏常州213164

出　　处：《中国矫形外科杂志》2019年第3期256-260,共5页Orthopedic Journal of China

基　　金：国家自然基金资助项目(编号:81371994);上海市卫计委科研项目(编号:201440016);浦东新区卫计委资助项目(编号:PW2017F-1);浦东新区卫生系统重点学科建设资助项目(编号:PWZXK2017-08)

摘　　要：[目的]探讨新型颈椎后路椎管成形桥接融合器在颈椎后路单开门椎管扩大成形术中的生物力学特性。[方法]以正常成年人4具尸体颈椎标本进行试验,制备后路椎管单开门模型,以右侧为轴,分别在左侧行新型桥接融合器(融合器组)、ARCH钛钢板(钛板组)和钛缆(钛缆组)固定,对三种固定以及原始标本进行6自由度的生物力学测试。[结果]四组间后伸、左侧弯、左旋转活动度间的差异有统计学意义(P<0.05),四组间在前屈、右侧弯和右旋转活动度的差异无统计学意义(P>0.05)。钛缆组的各方向活动度均大于融合器组、钛板组和原始对照组,差异有统计学意义(P<0.05)。融合器组各方向活动度均小于钛板组,在左侧弯及左旋状态下融合器组的活动范围与钛板组的差异有统计学意义(P<0.05),而在后伸、前屈及右侧弯状态下的活动范围融合器组与钛板组之间的差异无统计学意义(P>0.05)。[结论]生物力学试验中6自由度活动度测试显示在颈椎单开门椎管扩大成形术中应用新型桥接融合器内固定能维持较好的颈椎活动度,同时术后拥有良好的即刻稳定性,完全满足目前经后路椎管成形术的治疗要求。[Objective]To investigate the biomechanical properties of a novel cervical posterior lumbar bridging fusion cage for posterior cervical single open-door laminoplasty.[Methods] Four fresh cadaver cervical spines form healthy adults were used in this study.After posterior cervical single open-door laminoplasty models created on the specimens with axis on the right sides,the novel cervical posterior lumbar bridging fusion cage,arch plate and titanium cable were used for fixation of the laminoplasty on left sides.The 3 treated samples and a sample in original state were tested biomechanically in 6 degrees of freedom.[Results] Among the 4 groups,there were significant differences regarding to range of motion(ROM) in extension,left bending and left rotation(P<0.05),although no significant differences were noted in flexion,right bending and right rotation(P>0.05).The titanium cable group had significantly greater ROM in all direction than the fusion cage group,arch plate group and the original control group(P<0.05).The fusion cage group had less ROM in all directions than the arch plate group,which was statistically significant in left bending and left rotation(P<0.05),whereas not statistically significant in extension,flexion and right bending(P>0.05).[Conclusion] The 6 degree of freedom biomechanicaltests show that the new type of bridging fusion cage forinternal fixation of single open-door laminoplasty does maintain a proper degree of cervical motion,and restore the immediate stability as well,which meet the need of posterior open-door laminoplasty in clinical setting.

关 键 词：颈椎 后路手术 椎管扩大成形术 桥接融合器 生物力学 即刻稳定性 

分 类 号：R687[医药卫生—骨科学]