颈椎后路单开门椎管扩大椎板成形联合选择性融合术的生物力学研究  

Biomechanical study of cervical posterior open-door laminoplasty combined with selective fusion

作　　者：王亚楠 王建法 李亚威 刘军伟 张一 李志磊 孙国绍 邵世坤 WANG Ya-nan;WANG Jian-fa;LI Ya-wei;LIU Jun-wei;ZHANG Yi;LI Zhi-lei;SUN Guo-shao;SHAO Shi-kun(Department of Neurospinal Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou Henan 450000,China)

机构地区：[1]郑州大学附属郑州中心医院神经脊柱外科,河南郑州450000

出　　处：《局解手术学杂志》2022年第6期478-482,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：河南省医学科技攻关计划联合共建项目(2018020761)。

摘　　要：目的评估颈椎后路单开门椎管扩大椎板成形联合选择性融合术与颈椎后路单开门椎管扩大成形微型钛板内固定术在本地羊颈椎椎体不稳标本中的力学特点。方法取4具新鲜羊颈椎标本,每具标本分别制作为颈椎C3/4节段失稳标本(失稳标本)、颈椎后路单开门椎管扩大成形微型钛板内固定术标本(传统术式标本)、颈椎后路单开门椎管扩大椎板成形联合选择性融合术标本(改良术式标本),分别对每具标本进行生物力学测试。记录在X射线透视下羊颈椎在不同状态下的颈椎活动度(ROM)、颈椎屈曲度(CFA)和颈椎后伸度(CEA)。结果失稳标本与改良术式标本CFA、ROM比较,差异无统计学意义(P>0.05),失稳标本与改良术式标本的CEA比较,差异具有统计学意义(P<0.05);传统术式标本与改良术式标本的ROM比较,差异具有统计学意义(P<0.05),但传统术式标本与改良术式标本CFA及CEA比较,差异均无统计学意义(P>0.05);失稳标本与传统术式标本CFA、CEA及ROM比较,差异均无统计学意义(P>0.05)。结论与颈椎后路单开门椎管扩大成形微型钛板内固定术相比,颈椎后路单开门椎管扩大椎板成形联合选择性融合术能够在有效保留ROM的同时重建椎体稳定性。Objective To evaluate the mechanical characteristics of cervical posterior open-door laminoplasty combined with selective fusion and cervical posterior open-door laminoplasty with micro titanium plate internal fixationin in local sheep specimens of cervical instability.Methods Four fresh sheep cervical specimens were taken,and each specimen was made into the specimen of C3/4 segments instability(instability specimen),the specimen of cervical posterior open-door laminoplasty with micro titanium plate internal fixation(traditional surgical specimen),and the specimen of cervical posterior open-door laminoplasty combined with selective fusion(modified surgical specimen).The biomechanical tests were performed on each specimen respectively.The range of motion(ROM),cervical flexion angles(CFA)and cervical extension angles(CEA)of the cervical spine under different conditions were recorded with X-ray fluoroscopy.Results There was no significant difference in the CFA or ROM between the instability specimen and the modified surgical specimen(P>0.05).The difference of CEA between the instability specimen and the modified surgical specimen was statistically significant(P<0.05).There was statistically significant difference in the ROM between the traditional surgical specimen and modified surgical specimen(P<0.05).However,there was no significant difference in the CFA or CEA between the traditional surgical specimen and the modified surgical specimen(P>0.05).There was no significant difference in the CFA,CEA or ROM between the instability specimen and the traditional surgical specimen(P>0.05).Conclusion Compared with cervical posterior open-door laminoplasty with micro titanium plate internal fixation,cervical posterior open-door laminoplasty combined with selective fusion can effectively preserve the ROM while reconstructing the vertebral stability.

关 键 词：颈椎 椎管扩大成形 羊 内固定 

分 类 号：R318.01[医药卫生—生物医学工程]