| 摘要: |
| 目的:设计一种经侧后方斜向置入单枚多孔螺纹状融合器的椎间融合新技术,并对其进行生物力学评价。方法：小牛的脊柱标本12件，分为2组(n=6)，第一组经侧后方斜向置入加长的单枚椎间融合器；第二组经后路置入双枚椎间融合器。测定纵向压缩、屈曲、侧方弯曲、伸展及双向旋转刚度。第一次测试各组置入融合器后之刚度值，第二次测试各组增大融合器规格后之刚度值，第三次测试第一组附加小关节突螺钉内固定后之刚度值。结果：单枚融合器组的纵向压缩刚度、左侧（融合器植入侧）弯曲刚度、顺与逆时针旋转刚度均较双枚融合器组显著增大(P<0.05)。第一组试件，辅加小关节突螺丝钉固定后，伸展、双侧弯曲和顺时针旋转刚度有明显增加。单枚融合器组的右侧弯曲刚度较双枚融合器组下降。单枚融合器组，增大融合器规格可提高压缩刚度、伸展刚度、屈曲刚度，但右侧弯曲刚度及逆时针刚度下降。双枚融合器组增大融合器规格，刚度并无明显增大。结论：经侧后方斜向植入的单枚椎间融合器加上小关节突螺丝钉内固定融合术，在提供充分椎管减压的同时，具有损伤小、脊柱后部稳定性好、术中对马尾及神经根牵拉轻的优点，可以比较理想地取代后路双枚融合器椎间融合术。 |
| 关键词: 椎间融合器、椎体间融合术、生物力学 |
| DOI： |
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| 基金项目: |
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| Posterior lumbar interbody fusion with single posterolateral threaded cage insertion: a biomechanic evaluation |
| 袁汉生,陈德玉,海涌,王新伟,赵杰 |
| () |
| Abstract: |
| Objective:To compare the intervertebral segmental stiffness between PLIF with one long posterolateral cage, PLIF with one posterolateral cage and facet joint fixation, and PLIF with 2 posterior cages. Methods:Twelve bovine lumbar functional spinal units were divided into 2 groups. group 1 had a long single threaded cage inserted posterolaterally on the left side by posterior approach with left unilateral facetectomy; group 2 had 2 regular length cages inserted posteriorly. Nondestructive tests were performed in pure compression, flexion, extension, lateral bending, and rotation. Test order was intact, implanted 2 sizes, and group 1 with internal fixation of facet joint screw. Results: Group 1 had a significantly higher stiffness than group 2 in pure compression, left bending, and rotation (P＜0.05). group 2 had higher stiffness values than group 1 in right bending. Increase of cage size of group 1 increased the stiffness of pure compression, extension, flexion, and decreased the stiffness of right bending and contercolockwise rotation. Cage size had no significant effect on group 2. Group 1 with fixation of facet joint screw had a significant increase in stiffness for extension, bilaleral bending, and colockwise rotation. Conclusion:Posterior lumbar interbody fusion with insertion of a single long threaded cage posterolaterally with unilateral facetectomy enables sufficient decompression while maintaining a majority of the posterior elements. Combined with a facet joint screw, adequate postoperative stability can be achieved. |
| Key words: interbody fusion cage interbody fusion biomechanics |
