|
|
- 2016
可动人工颈椎假体的研制及生物力学研究
|
Abstract:
摘要：目的 研制一种既能重建颈椎体高度又能保留相应椎间隙运动功能的可动人工颈椎假体并研究其生物力学特性。方法 10具新鲜颈椎标本(C4～T1)先后作为完整组、融合组(C4～C6)和非融合组(假体植入在C5)，在1.5Nm扭矩下进行初步生物力学活动度测试，记录C4-5、C5-6、C6-7、C4-7的运动范围，并进行单因素方差分析和多重比较。结果 与融合组相比，非融合组标本能显著保留C4-5和C5-6的运动范围、降低C6-7的运动范围。与完整组相比，非融合组各椎间隙的运动范围无显著性差异。结论 可动人工颈椎在植入颈椎标本后能重建相应颈椎节段的稳定性且能保留相应椎间隙的活动度。
ABSTRACT: Objective To design a cervical artificial disc and vertebra system and to evaluate its biomechanical characteristics. Methods Ten fresh human cervical spine specimens (C4-T1) were included in this study. The specimens were tested as in the status of intact, fusion (C4-C6) and non-fusion in sequence under 1.5 Nm torque by an MTS. Ranges of motion of C4-5, C5-6, C6-7 and C4-7 were recorded and compared. Results Significantly increased range of motion of C4-5 and C5-6, as well as decreased range of motion of C6-7 of the specimens in non-fusion group were observed compared with those in the fusion group. There was no significant difference in the range of motion between the non-fusion and intact groups. Conclusion Cervical artificial disc and vertebra system can reconstruct the height of vertebra and preserve the range of motion of the operative levels after its implantation into the cervical spine specimen
| [1] | DONG J, LU M, LU T, et al. Meta-analysis comparing zero-profile spacer and anterior plate in anterior cervical fusion[J]. PLoS One, 2015,10(6):e0130223. |
| [2] | ZHANG Y, QUAN Z, ZHAO Z, et al. Evaluation of anterior cervical reconstruction with titanium mesh cages versus nano-hydroxyapatite/polyamide66 cages after 1- or 2-level corpectomy for multilevel cervical spondylotic myelopathy: a retrospective study of 117 patients[J]. PLoS One, 2014, 9(5):e96265. |
| [3] | SAAVEDRA-POZO FM, DEUSDARA RA, BENZEL EC. Adjacent segment disease perspective and review of the literature[J]. Ochsner J, 2014, 14(1):78-83. |
| [4] | BROWN JA, HAVEL P, EBRAHEIM N, et al. Cervical stabilization by plate and boe fusion[J]. Spine (Phila Pa 1976), 1988, 13(3):236-240. |
| [5] | KRETZER RM, HSU W, HU N, et al. Adjacent-level range of motion and intradiscal pressure after posterior cervical decompression and fixation. An ？？in vitro ？？human cadaveric model[J]. Spine (Phila Pa 1976), 2012, 37(13):E778-E785. |
| [6] | 2015, 40(16):1277-1283. |
| [7] | 《中国组织工程研究与临床康复》杂志社学术部. 中国自制人工椎体的设计与应用技术进展[J]. 中国组织工程研究与临床康复, 2011, 15(39):7364-7365. |
| [8] | CHEN JF, LEE ST. Antibiotic-polymethylmethacrylate strut: an option for treating cervical pyogenic spondylitis[J]. J Neurosurg Spine, 2006, 5(1):90-95. |
| [9] | 吕超亮，宋跃明，刘浩，等. 纳米羟基磷灰石/聚酰胺66椎体支撑体在下颈椎骨折脱位前路手术重建中的应用[J]. 中华外科杂志, 2012, 50(4):338-341. |
| [10] | GIRARD V, LEROUX B, BRUN V, et al. Post-traumatic lower cervical spine instability: Arthrodesis clinical and radiological outcomes at 5years[J]. Orthop Traumatol Surg Res, 2014, 100(4):385-388. |
| [11] | CHUNG JY, KIM SK, JUNG ST, et al. Clinical adjacent-segment pathology after anterior cervical discectomy and fusion: results after a minimum of 10-year follow-up[J]. Spine J, 2014, 14(10):2290-2298. |
| [12] | HILIBRAND AS, ROBBINS M. Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion[J]? Spine J, 2004, 4(6 Suppl):190S-194S. |
| [13] | BABA H, FURUSAWA N, IMURA S, et al. Late radiographic findings after anterior cervical fusion for spondylotic myeloradiculopathy[J]. Spine (Phila Pa 1976), 1993, 18(15):2167-2173. |
| [14] | FERMANDES PC, FEMANDES PR, FOLGADO JO, et al. Biomechanical analysis of the anterior cervical fusion[J]. Comput Methods Biomech Biomed Engin, 2012, 15(12):1337-1346. |
| [15] | CASON GW, HERKOWITZ HN. Cervical intervertebral disc replacement[J]. J Bone Joint Surg Am, 2013, 95(3): 279-285. |
| [16] | ALVIN MD, ABBOTT EE, LUBELSKI D, et al. Cervical arthroplasty: a critical review of the literature[J]. Spine J, 2014, 14(9): 2231-2245. |
| [17] | MAO N, WU J, ZHANG Y, et al. A comparison of anterior cervical corpectomy and fusion combined with artificial disc replacement and cage fusion in patients with multilevel cervical spondylotic myelopathy[J]. Spine (Phila Pa 1976), |
| [18] | KOEHLER S, RASLAN F, STETTER C, et al. Autologous bone graft versus PEKK cage for vertebral replacement after 1- or 2-level anterior median corpectomy[J]. J Neurosurg Spine, 2016, 24(2):309-314. |
| [19] | BOLESTA MJ, RECHTINE GR 2nd, CHRIN AM. One- and two-level anterior cervical discectomy and fusion: the effect of plate fixation[J]. Spine J, 2002, 2(3):197-203. |
| [20] | PARK YK, MOON HJ, KWON TH, et al. Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy[J]. Eur Spine J, 2013, 22(7):1489-1496. |
| [21] | WANG CS, CHANG JH, CHANG TS, et al. Loading effects of anterior cervical spine fusion on adjacent segments[J]. Kaohsi J Med Sci, 2012, 28(11):586-594. |
