摘要
目的 研究椎体终板在脊柱前路椎体间植骨融合手术中的作用。 方法 将 2 1只家犬按 4 ,8,1 2周 3个时相点随机分成 3组 ,每组 7只。采用自身对照 ,在每只犬的 2个腰椎间隙制成保留终板 (实验组 )和不保留终板 (对照组 )的前路椎体间植骨融合术模型 ,应用组织学、生物力学的方法对两组的植骨愈合情况进行比较 ,并用免疫组化方法标记植骨界面的新生血管情况 ,同时比较两组标本的抗压性能。 结果 (1 )术后 4周时实验组的植骨愈合情况差于对照组 ,8周时趋于相等 ,1 2周时无差别。 (2 )术后 4周时实验组新生血管数量少于对照组 ,8周时差别减小 ,1 2周时两组基本相等。 (3)引起实验组植骨间隙 1mm位移时的抗压强度大于对照组 (P <0 .0 5)。 结论 保留终板的脊柱前路椎体间植骨融合术有较好的生物力学性能 ,且终板的保留不会对植骨愈合的整体进程有明显影响 ,因而是一种较好的手术方式。
Objective To study the role of endplate in anterior interbody spinal fusion. Methods A group of 21 adult dogs were divided into 3 groups (7 dogs in each group) according to different postoperative time. Two procedures of anterior lumbar fusion with endplate preserved (Group Ⅰ) or without endplate preserved (Group Ⅱ) were performed in two different lumbar disc spaces in every dog. Then, the healing of the grafts applying two different techniques was compared by different methods: (1) Histology of the specimens of different postoperative period. (2) Immunostaining using an anti von Willebrand Factor (vWF) antibody to mark the endothelial cell of blood vessels in the grafting region. (3) The biomechanics of axial torsion of the specimen in different post operative time and the biomechanics of axial compression of two artificial surgical models in vitro. Results (1) Histologically, there were less newborn matrix and blood vessels in the Group Ⅰ than those in the Group Ⅱ after 4 weeks. At the 8th week, there appeared same condition of fusion. Both groups showed bony fusion in 12 weeks. (2) Through immunostaining, the density of the vessels was more intensive in the Group Ⅱ than that in the Group Ⅰ. It trended to be equal in 8 weeks without difference between the two groups in 12 weeks. (3) The biomechanical strength of axial torsion of the functional spinal units after 4 weeks in the Group Ⅱ was greater than that in the Group Ⅰ( P <0.05) under different twisting angles without statistical difference between the two groups in 8 weeks. The biomechanical strength of axial compression which caused the graft of 1 mm migration in the Group Ⅰwas greater than that in the Group Ⅱ( P <0.05). Conclusions The procedure of anterior interbody spinal fusion with endplate preserved has better biomechamical performance than that of without endplate preserved. In the mean time, the healing of bone grate. So we think the procedure with endplate preserved is a better choice for anterir interbody
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2002年第7期423-427,共5页
Chinese Journal of Trauma
关键词
脊柱损伤
脊柱融合术
骨移植
生物力学
植骨愈合
Spinal cord injuries
Spinal fusion
Bone transplantation
Biomechanics
Healing of bone graft
