摘要
背景:各种椎间融合器(cage)已相继被用于腰椎椎间融合,其力学性能良好,临床效果满意。常规的后路融合要平行置入双枚cage,但有学者提出可以斜向置入单枚cage的方法。目的:实验设计方案特点在于将膨胀式cage和斜向置入单枚cage的方法相结合,通过人体外的生物力学试验,以得到一种在临床上能满足治疗要求而创伤更小的方法。设计、时间及地点:随机抽样对照实验,于2005-05/2008-05在上海生物力学工程研究所完成。材料:可膨胀式椎间融合器采用仿制的以色列Disc-O-Tech公司生产的B-TwinCage。小牛新鲜腰椎标本自购自备。方法:用18具小牛腰椎运动功能单位进行生物力学试验,分为3组,对照组、单枚斜向组及双枚平行组各6个。先测试对照组完整标本力学性能而后分组置入进行力学试验。采用WE-10A液压万能试验机,对标本进行轴向中心压缩、前屈、后伸、左右侧屈以及扭转刚度试验。主要观察指标:各组标本的轴向刚度及扭转刚度结果。结果:双枚cage置入组比单枚cage置入组的轴向刚度高,但只有轴向中心压缩和后伸运动方向的差异有显著性意义(P<0.05),扭转刚度单枚cage置入组较双枚cage置入组高(P<0.05)。结论:经皮穿刺斜入路放置单枚膨胀式椎间融合器进行椎间骨融合从理论上是可行的;置入膨胀式融合器的腰椎功能单元的生物力学稳定性能增强,其楔形形状有一定作用;与经侧后路斜向置入单枚cage相比,经后路平行置入双枚cage的轴向稳定性高,但扭转稳定性低。
BACKGROUND： A variety of cages for lumbar interbody fusion have been used, which have good mechanics and clinical effects. Conventional posterior fusion requires parallel implantation of two cages, but some researchers believe that single lumbar fusion cage in oblique way is also possible.
OBJECTIVE： Through in vitro biomechanical tests, to find a method with favorable effect and little trauma by combination of percutaneous lateral oblique way into the single expansive lumbar fusion cage between the fixed-line operations.
DESIGN, TIME AND SETTING： A randomized, controlled experiment was performed at the Shanghai Institute of Biomechanical Engineering between May 2005 and May 2008.
MATERIALS： Expansile lumbar interbody fusion cage was simulated from B-Twin Cage （Disc-O-Tech, Israel）. Fresh calf lumbar specimens were used.
METHODS： Biomechanical tests were performed in 18 specimens of calf lumbar function spinal units （FSU）, which were divided into 3 groups： 6 in control group, 6 in single cage groups and 6 in two-cage groups. The biomechanical tests of two experimental groups were performed following tests of intact specimens. Stiffness tests were conducted in the WE-10A MTS, including axial compression, flexion, extension, lateral bending, and torsion. MAIN OUTCOME MEASURES： Axial and torsion stiffness results of each group.
RESULTS： The stiffness was greater in two-cage groups compared with single cage group in axial compression and extension, but significant differences were only found in axial compression and extension tests （P 〈 0.05）. The torsion stiffness of single cage group was significantly greater than two-cage groups （P 〈 0.05）. CONCLUSION： Percutanous lumbar interbody fusion by single expansile lumbar interbody fusion cage from lateral approach is feasible theoretically. Biomechanical properties of FSU with B-Twin cage are improved, which contributes a lot to lumbar stability. Compared with posterior approach of single cage, two-cage can provide better s
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第39期7643-7646,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
