牛胸腰椎不同内植物的破坏载荷测试(英文)  

Measurement of load to collapse of different implants of thoracic lumbar spinal constructs in bovine model

作　　者：王新伟[1] 陈德玉[1] 卢旭华[1] 郭永飞[1] 张涛[1] 赵定麟[1] 

机构地区：[1]解放军第二军医大学长征医院骨科,上海市200003

出　　处：《中国临床康复》2004年第17期3384-3385,共2页Chinese Journal of Clinical Rehabilitation

基　　金：上海市科委资助项目(024419126)~~

摘　　要：背景:胸腰椎椎体切除后的脊柱重建方法有多种,但不同内植物的破坏载荷评价并未受到广泛重视。目的:测试牛胸腰椎椎体切除后不同内植物重建的破坏载荷。设计:随机对照实验。地点和对象:实验在上海大学完成,21具小于6周的小牛胸腰椎标本,由上海光明牛奶厂提供。干预:标本随机分为对照组、髂骨植骨组、人工椎体替代组、髂骨植骨+前路钢板组、人工椎体+前路钢板组、髂骨植骨+椎弓根钉组及人工椎体+椎弓根钉等7组。以50N开始加载,直至标本破坏。主要观察指标:测量各标本在屈曲压缩状态下的最大破坏载荷。结果:正常小牛胸腰椎标本的极限载荷最高,平均为1050N,髂骨植骨组的最小,为80N,仅有原始标本的45%,单纯钛合金人工椎体组平均破坏载荷比髂骨植骨组高16%,附加前路钢板及后路椎弓根钉固定,破坏载荷均高于单纯植入者。结论:不管是人工椎体还是髂骨替代其破坏载荷均小于原始标本,椎体重建的远期目标是融合而不是支撑。BACKGROUND:Several methods have been described for spinal reconstruction after thoracic lumbar corpectomy.However,the load to collapse of different implants has not been widely emphasized and evaluated. OBJECTIVE:To investigate the load to collapse of different implants in thoracic lumbar spine. DESIGN:A randomized controlled experiment was conducted. SETTING and PARTICIPANTS:Twenty one bovine thoracic and lumbar spine specimens under 6 weeks old were provided by Shanghai Bright Dairy.The experiment was finished in Shanghai University,Shanghai,China. INTERVENTIONS:The specimens were divided into seven groups which were control group(Intact spine,IS),iliac bone graft group(IBG),AHT AVB group(AVB),IBG supplemented with anterior plate group(IBG+AP),AVB supplemented with anterior plate group(AVB+AP),IBG supplemented with posterior pedicle screw group(IBG+PS) and AVB supplemented with posterior pedicle screw group(AVB+PS).Loading began from 50 N until the specimen was collapsed. MAIN OUTCOME MEASURES:The load to collapse under flextional compression were tested and determined for each specimen. RESULTS:The load to collapse in intact specimen is the highest with the mean score of 1 050 N while the iliac group is the lowest with the mean score of 80 N only which is 45%of the intact specimen.The average load to collapse in AVB fixation alone group is 16%higher than those in iliac bone graft group.After supplemented with anterior plate or posterior pedicel screw the load to failure value increased. CONCLUSION:Both the IBG and AVB group has the lower load to collapse comparing with the IS group.The long term objective of vertebral reconstruction is fusion but not shoring.

关 键 词：牛 内植物 破坏载荷 测试 腰椎椎体切除 人工椎体 椎弓根钉 髂骨植骨 

分 类 号：R681.5[医药卫生—骨科学]