摘要
目的 探讨螺纹异体骨椎间融合支架 (allograftinterbodyfusioncage ,AIFC)腰椎间融合的生物力学特性及临床效果。 方法 用 4具新鲜尸体的尺骨、桡骨和腓骨自行研制成AIFC ,同时用环钻切取带双面皮质的髂骨行压缩试验 ,并模拟临床切除L2～ 3,L4～ 5椎间盘后分别植入髂骨和AIFC ,行拔出试验。将AIFC用于 10例腰椎滑脱和腰椎不稳病人 ,观察其临床效果及手术并发症 ,并做X线征评价。结果 ①最大抗压负荷AIFC组为 82 6 8± 490 3N ,髂骨组为 1385± 2 2 3N ,AIFC组为髂骨组的 6倍 (P <0 0 1) ,②最大拔出力AIFC组为 489± 2 0 6N ,髂骨组为 89± 45N ,AIFC组为髂骨组的 5 5倍 (P <0 0 1) ,③手术治疗 10例 ,平均随访 12个月 ,临床效果满意 ,无神经并发症发生。AIFC无移位及骨折。术后 3个月动态摄X线片均获骨性融合。手术椎间隙无高度丢失和畸形。结论 AIFC具有足够的支撑、维持或增加椎间隙高度功能 ,抗滑、稳定性好 ,椎间融合率高 ,其设计独特合理 。
Objective To investigate biomechanical feature and clinical result of using allograft interbody fusion cage (AIFC) for lumbar interbody fusion Methods The AIFC were made of ulnar,radius, fibula from 4 individual donors and cylindrical iliac bone were harvested simultaneously with the trephine cutter from iliac crests The compression test of the material were performed in vitro Resection of the L 2～3 and L 4～5 intervertebral discs were done with the trephine cutter to simulate a lumbar surgical procedures, AIFC and iliac bone blocks were insertde respectively in the intervertebral spaces and segment pull out test were performed Ten cases of lumber spodylolisthesis were treated with anterior or posterior decompression combine with AIFC from July 1998 to June 2000 The clinical result, radiographic outcome and the operation complication were observed Results Maximum compressive load and drawing load were 8268±4905N and 498±206N respectively in AIFC group, but these were 1385±223N and 89±45N respectively in the iliac bone group, there were significant greater in AIFC group than in iliac group (P<0 01), Ten cases had excellent results with an average of 12 month follow up No neurologic complications were seen No fracture and dislodgement were observed in AIFC.The height of interspace was maintained All segment had solid fusion Conclusion AIFC could provide enough support, anti slide ability and could remain or increase the height of intervertebral space The fusion rate was similar to that of autograft The design is distinctive and reasonable It completely meets biomechanical and clinical requirements
出处
《骨与关节损伤杂志》
2001年第1期14-16,共3页
The Journal of Bone and Joint Injury
基金
兰州军区资助课题!(LXH99 1 9)
