部分可吸收椎间融合器用于山羊腰椎融合效果评价  

Effect analysis of partially absorbable fusion cage in goat lumbar interbody fusion

作　　者：马金梁[1] 祝利平[1] 刘克斌[1] 邓忠良[2] 

机构地区：[1]荆州市第一人民医院骨科,湖北荆州434001 [2]重庆医科大学附属第二医院骨科,重庆400010

出　　处：《生物骨科材料与临床研究》2015年第6期5-9,I0006,I0007,共7页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：重庆市卫生局自助项目(2011-0-053);863计划(2008AA02Z443)

摘　　要：目的评估部分可吸收椎间融合器(PBIFC)用于山羊腰椎融合的效果。方法采用16只中国青山羊行腰椎间融合术。每只动物于L_(2-5)3个椎间隙随机植入PBIFC、n HA/PA66 cage或1枚自体髂骨块。术后即刻及每4周拍摄腰椎侧位X线片。术后24周处死动物行CT扫描、组织学和生物力学评估。结果术后12周内X线评估显示,髂骨组和PBIFC组可观察到椎间融合,而n HA/PA66组在此期间内未见融合;术后24周CT评估显示PBIFC组的融合度评分高于n HA/PA66组,有统计学意义(<0.05);生物力学测试显示PBIFC组平均刚度大于髂骨组,而髂骨组大于n HA/PA66组,均有显著性差异(<0.05);组织学评估:PBIFC组在植骨区和椎间融合器边缘可见大量成熟的骨小梁,骨组织与材料表面已发生嵌合;髂骨组的植骨块与椎体间的新生骨小梁已改建为成熟的骨小梁;n HA/PA66组可见纤维骨痂形成。结论 PBIFC具有良好的生物力学特性,融合率高,可进一步用于临床试验研究。Objective According to goat radiological, histological and biomechanical properties 6 months after surgery,the effect of partially bioabsorbable interbody fusion cage in lumbar interbody fusion（PBIFC） was assessed. Methods16 Chinese grey goats were subjected to lumbar interbody fusion surgery. Two types of case and one autologous iliac bone graft were respectively implanted in L_（2-5） intervertebral spaces in each goat. X-ray examination of lumbar spine in lateral position was performed immediately after the surgery and every month. 24 weeks after the surgery,the goats were sacrificed for CT scan, histological and biomechanical assessment. Results Lumbar interbody fusion was observed in iliac bone graft group and PBIFC group in X-ray images 3 months after the surgery; no lumbar interbody fusion was observed in n HA/PA66 group. X-ray and CT scan indicated that the lumbar interbody fusion rate in PBIFC group at the 6th month after surgery was 69%（11/16）, 75%（12/16） in iliac bone graft group, and 31%（5/16） in n HA/PA66 group（P〈0.05）.Biomechanical test showed that the average stiffness in PBIFC group was greater than that in iliac bone graft group; the average stiffness was the smallest in n HA/PA66 group; the difference was significant（P〈0.05）. Histological assessment：the formation of large quantity of mature bone trabecula was observed in the implant bone graft area and on the edge of interbody fusion cage. In PBIFC group, large quantity of fibrous callus and new bone are formed between the implant and the tissues; gomphosis between the bone tissues and the implant surface was formed. In iliac bone graft group, the new bone trabecula between the implant bone graft and lumbar vertebra was remolded to be mature bone trabecula. In n HA/PA66 group, the formation of much fibrous callus was observed. Conclusion PBIFC had good biomechanical properties and high lumbar interbody fusion rate in goat lumbar interbody fusion, and was proven to be an ideal in lumbar interbody fusion.

关 键 词：腰椎融合 椎间融合器 多聚氨基酸 硫酸钙 生物可吸收植入物 

分 类 号：R687.3[医药卫生—骨科学]