摘要
目的 评价一种新型内置物钛网融合器 (titaniummeshcage)在胸腰段脊柱不稳重建术中应用的生物力学特性。 方法 取 8个新鲜冷藏的人尸体脊柱标本 (T1 1 ～L3) ,分别行L1 椎体次全切除 ,T1 2 、L1 和L1 ,2 椎间盘全切除 ,制作损伤后减压失稳模型 ,依次实施四种重建术式。 (1)髂骨块植入加前路Kaneda钢板固定 ;(2 )钛网融合器内松质骨植入 ;(3)钛网和前路Kaneda钢板联合应用 ;(4)钛网和后路TSRH椎弓根钉系统联合应用。对上述试件依次分组进行生物力学稳定性测试。 结果 钛网融合器的置入使失稳脊柱的稳定性提高 ,其侧弯、屈伸运动度减少 ,与完整脊柱组比较 ,差异有显著性意义 (P <0 .0 5 ) ,相反 ,抗旋转运动减少不明显 (P >0 .0 5 ) ;钛网融合器无论与前路或后路固定器的联合使用 ,均可使失稳脊柱节段在各方向的运动度显著减少 ,与完整脊柱组比较 ,差异有非常显著性意义 (P <0 .0 1)。 结论 钛网融合器的置入在失稳胸腰段脊柱的前路重建术中 ,具有提高稳定性、恢复和维持脊柱正常形态的作用。与前后路内固定器联合使用可提高其生物力学效应。
Objective To evaluate the biomechanical properties of a new implant titanium mesh cage in anterior reconstruction of unstable thoracolumbar spine. Methods Eight fresh frozen human cadaveric spinal specimens (T 11～L 3) were used in this biomechanical test. L 1 was given vertebrectomy, and T 12～L 1 and L 1～2 discectomy. Following an establishment of a post-injury decompression lose-control model post injury, the four constructions were performed: (1) bone-graft with anterior Kaneda steel plate fixation, (2) mesh cage interbody fusion device, (3) mesh cage with Kaneda fixation and (4) mesh cage with posterior pedicle screw system TSRH. Their biomechanic stabilities were tested in all groups. Results Titanium mesh cage improved the stability of the unstable spine and decreased the flexion, the lateral bending or the extension with a significant difference compared with intact group (P<0.05). Whereas, axial rotational motion was decreased insignificantly (P>0.05). Mesh cage combined with anterior or posterior fixations improved greatly the segmental stability, with a significant difference compared with the intact spine (P<0.01). Conclusions The titanium mesh cage is effective in restoring spinal lordosis, keeping normal form of the spine and improving the segmental stability. A combination employment with anterior or posterior fixations in the thoracolumber spine may intensify their biomechanical properties.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2003年第1期31-33,共3页
Chinese Journal of Trauma
关键词
脊柱损伤
内固定器
生物力学
钛网融合器
Spinal injuries
Internal fixators
Biomechanics
Titanium mesh cage
