基于Mimics测量CT扫描数据二段可调式新型纳米羟基磷灰石/聚酰胺66复合材料人工假体的设计  

Design of a novel two-segment adjustable nano-hydroxyapatite/polyamide 66 artificial prosthesis based on Mimics measurements of CT scan data

作　　者：陈广辉 成立[2] 王健 黄权 白广建 尹萌辰 魏海峰 杨诚 肖建如 刘铁龙 Chen Guang-hui;Cheng Li;Wang Jian;Huang Quan;Bai Guang-jian;Yin Meng-chen;Wei Hai-feng;Yang Cheng;Xiao Jian-ru;Liu Tie-long(Department of Oncology,Changzheng Hospital,Second Military Medical University of PLA,Shanghai 200003,China;Department of Orthopedics,Cixi People’s Hospital,Cixi 315300,Zhejiang Province,China;Department of Orthopedics,People’s Hospital of Shanghai Pudong District,Shanghai 200000,China;Taishan Medical University,Taian 271016,Shandong Province,China;Department of Orthopedics,Longhua Hospital,Shanghai 200000,China)

机构地区：[1]上海长征医院骨肿瘤科,上海市200003 [2]慈溪市人民医院骨科,浙江省慈溪市315300 [3]上海浦东新区人民医院骨科,上海市200000 [4]泰山医学院,山东省泰安市271016 [5]上海市龙华医院骨科,上海市200000

出　　处：《中国组织工程研究》2018年第26期4133-4138,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金面上项目(51573207);宁波市自然科学基金(2016A610006)~~

摘　　要：背景:目前临床常用的脊柱修复重建假体由于其具有材质刚度较大且与相邻终板接触面积太小等缺点,易产生应力遮挡,导致术后骨折不愈合及局部骨质吸收等问题的发生。随着固定时间的不断延长,内固定易出现疲劳性断裂,导致内固定失败。目的:利用Mimics软件测量腰椎的CT扫描数据设计二段可调式新型人工假体。方法:选取60例中青年男性住院患者腰椎CT扫描数据,导入Mimics软件中进行骨骼轮廓提取划分,分别测量记录L1-3椎体高度及上下终板横径、矢状径、矢状面凹陷角及冠状面凹陷角等指标,依照所测数据设计高度可调且两端接触面与相邻椎体终板相贴合的新型人工假体。结果与结论:(1)利用Mimics软件精确划分提取了所有病例资料的L1-3椎体数据。经过测量分析,L1-3椎体高度,上下终板矢状径及矢状面凹陷角差异无显著性意义,L1-3椎体上终板横径均小于同椎体下终板(P<0.05),冠状面凹陷角差异明显(P<0.05);(2)根据所测椎体高度及终板矢状径、矢状面凹陷角等数据结果设计出高度可调新型人工假体。该假体以纳米羟基磷灰石/聚酰胺66复合材料为基础,由顶盖和底座两部分相互嵌套组成,术中可通过底座侧孔注入骨水泥实现假体高度调节。该假体两端接触面与相邻终板紧密贴合、足够的接触面积能有效减少应力集中,促进假体与终板的骨质愈合;(3)结果说明,试验利用Mimics软件测量腰椎的CT扫描数据设计二段可调式新型人工假体设计合理,操作方便。BACKGROUND： Previous studies have shown that commonly used prostheses for spinal repair are prone to have stress shielding effects （nonunion and local bone resorption） due to their limited high elastic modulus and limited contact areas, which can lead to the failure of internal fixation over time. OBJECTIVE： To design a novel two-segment adjustable artificial vertebral body through the measurement of CT scan data of the vertebral body using Mimics software. METHODS： Sixty young and middle-aged male patients with lumbar CT scan data were included. Mimics software was used to extract the skeleton contour of L1-3 vertebrae and to measure the vertebral body height and the transverse diameter of the upper and lower end plates, sagittal diameter, sagittal and coronal concave angles. Based on the measured data, a new type of artificial vertebral body adjustably and anatomically fitting the vertebral endplate was designed. RESULTS AND CONCLUSION： There was no significant difference in the L1-3 height and sagittal diameter of the upper and lower endplates, and sagittal concave angle among all the cases. The transverse diameter of the upper endplate was significantly less than that of the lower endplate in the same vertebra （P 〈 0.05）. A significant difference in the sagittal concave angle was also found （P 〈 0.05）. Based on the measured vertebral height, sagittal diameter of the endplate and sagittal concave angle, a novel artificial vertebral body with adjustable height was designed. The new product made of nano-hydroxyapatite/polyamide 66 was composed of a top cover and a base. The height of thedesigned vertebral body could be controlled by bone cement injection via the side hole on the base. And it could be tightly integrated with the upper and lower endplates of the adjacent vertebral body, which is beneficial to promote the osseointegration. In conclusion, the two-segment adjustable artificial vertebral body has the advantages of reasonable design and convenient operation.

关 键 词：椎体高度 终板形态学 解剖学 CT扫描 纳米羟基磷灰石/聚酰胺66复合材料 生物材料 人工假体 MIMICS 矢状径 终板横径 组织工程 

分 类 号：R318[医药卫生—生物医学工程]