非固定状态下椎板重建对兔脊柱稳定性的影响  

Effect of vertebral lamina reconstruction on spinal stability in rabbits under unstable condition

作　　者：刘学鹏 孙甲树 张引锋 孙海燕 Liu Xuepeng;Sun Jiashu;Zhang Yinfeng;Sun Haiyan(Department of Orthopaedics,Sunshine-Union Hospital,Weifang 261000,Shandong,China;Department of Orthopaedics,Zibo First Hospital,Zibo 255200,Shandong,China)

机构地区：[1]阳光融和医院骨科,潍坊261000 [2]淄博市第一医院骨科,淄博255200

出　　处：《脊柱外科杂志》2023年第6期411-416,共6页Journal of Spinal Surgery

摘　　要：目的研究非固定状态下椎板重建对兔脊柱稳定性的影响。方法利用自体微小骨粒与不同比例的纳米羟基磷灰石复合物修复全椎板切除术后的兔椎板缺损,通过手触、组织学检查、生物力学测试评估其骨发生、椎板重建和对脊柱稳定性的影响。48只新西兰大白兔平均分为4组,每组12只:A组,自体微小骨粒植骨;B组,自体微小骨粒与纳米羟基磷灰石以3∶1的比例混合后进行植骨;C组,自体微小骨粒与纳米羟基磷灰石以1∶1的比例混合后进行植骨;D组,不植骨,仅放置明胶海绵。结果A、B、C组大体标本可见新生椎板形态正常,骨质愈合,纤维组织增生连接,骨桥形成,植骨处骨痂愈合良好;D组为纤维结缔组织愈合。组织学观察A、B、C组均可见新生软骨及成骨,基本没有炎性反应,B、C组自体髂骨与人工骨无明显相互促进作用,也无抑制作用;D组仅见纤维结缔组织增生。生物力学实验表明,A、B、C组在植骨段强度及刚度方面差异无统计学意义(P>0.05);与D组相比,差异均有统计学意义(P<0.05)。结论非固定状态下兔椎板切除术后椎板间植骨能增加其脊柱稳定性。Objective To evaluate the influence of lamina reconstruction on spinal stability in rabbits under unstable condition.Methods The autologous micro bone particles and nano hydroxyapatite composites with different proportions were used to repair the defects of rabbit vertebral lamina after total laminectomy.The osteogenesis,reconstruction of vertebral lamina and effects on spinal stability were evaluated by hand touch,histological examination and biomechanical test.A total of 48 New Zealand white rabbits were divided into 4 groups,with 12 in each group:group A,bone grafting with autologous small bone particles;group B,bone grafting with autologous micro bone particles mixed with nano-hydroxyapatite(3∶1);group C,bone grafting with autologous micro bone particles and nano-hydroxyapatite(1∶1);group D,placed gelatin sponge without bone grafting.Results The gross specimens of groups A,B and C showed normal morphology of the newly formed vertebral lamina,bone healing,fibrous tissue hyperplasia and connection,bone bridge formation,and good healing of the callus at the bone graft site;group D showed fibrous connective tissue healing.Histological observation showed that new cartilage and osteogenesis were observed in groups A,B and C with almost no inflammatory response.In groups B and C,there was no significant mutual promotion or inhibitory effect between autologous iliac bone and artificial bone;In group D,only fibrous connective tissue hyperplasia was observed.Biomechanical experiments showed that there was no statistically significant difference in the strength and stiffness of the bone graft segment between the 3 groups undergoing bone grafting(P>0.05);compared with the group D,the differences were statistically significant(P<0.05).Conclusion Bone grafting between vertebral lamina after laminectomy under unstable condition can increase spinal stability in rabbits.

关 键 词：椎板切除术 骨移植 生物力学 兔 

分 类 号：R318.01[医药卫生—生物医学工程]