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1. 重庆医科大学附属第二医院骨科,重庆,400010
2. 重庆大学生物工程学院生物材料与仿生工程研究中心,重庆,400030
纸质出版日期:2018,
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罗帅红, 邓忠良, 田冬冬, 等. 可吸收形状记忆聚氨酯腰椎间融合器的生物力学评价[J]. 重庆医科大学学报, 2018,43(1):130.
Luo Shuaihong, Deng Zhongliang, Tian Dongdong, et al. Biomechanical evaluation of absorbable shape memory polyurethane lumbar interbody fusion cage[J]. Journal of Chongqing Medical University, 2018,43(1):130.
目的:评价自主研制的可吸收形状记忆聚氨酯(shape memory polyurethane,SMPU)腰椎间融合器(cage)在尸体腰椎单节段的生物力学特性。方法:将15具腰骶椎(L1~S1)标本随机分为3组:自体髂骨组(n=5),SMPU cage组(n=5),聚醚醚酮(polyetheretherketone,PEEK)cage组(n=5)。通过腰椎侧方入路,摘除L3~4椎间盘髓核后植入3种内植物,在力学试验机上测试每组标本术前与术后的运动范围(range of motion,ROM)及轴向破坏载荷。结果:ROM结果显示:术前自体髂骨组、SMPU cage组及PEEK cage组在前屈、后伸、左侧弯、右侧弯、左旋转、右旋转6个方向上的ROM相比较,差异均无统计学意义(P>0.05)。自体髂骨组在6个方向上的术后ROM均较术前明显增加(P<0.05);SMPU cage组在6个方向上的术后ROM均较术前明显减少(P<0.05);PEEK cage组在6个方向上的术后ROM均较术前明显减少(P<0.05)。SMPU cage组与PEEK cage组术后在6个方向上的ROM均明显低于自体髂骨组(P<0.05);SMPU cage组与PEEK cage组术后在6个方向上的ROM相比较,差异无统计学意义(P>0.05)。轴向压缩测试结果显示:PEEK cage组的破坏载荷较SMPU cage组和自体髂骨组明显增加(P=0.000),SMPU cage组的破坏载荷较自体髂骨组明显增加(P=0.000)。结论:SMPU cage能满足腰椎椎间融合的初始稳定性,并能够承载腰椎的生理负荷。
Objective:To evaluate the biomechanical properties of the self-designed absorbable lumbar interbody fusion cage in a sin-gle-level of cadaveric lumbar spine. Methods:Fifteen lumbosacral(L1-S1) specimens were randomly divided into three groups:auto-genous iliac bone group(n=5),shape memory polyurethane(SMPU) cage group(n=5),polyetheretherketone(PEEK) cage group(n=5). Three different intervertebral implants were implanted by lateral lumbar interbody fusion after complete discectomy(L3-4) was per-formed. The axial failure load and ROM between preoperation and postoperation were tested by a mechanical testing machine. Results:The ROM showed that there was no observed statistical difference in the preoperative ROM of all directions among three groups(P>0.05). In the autogenous iliac bone group,the ROM in all directions of postoperation was significantly higher than that of preoperation(P<0.05). In the SMPU cage group,the ROM in all directions of postoperation was significantly lower than that of preop-eration(P<0.05). In the PEEK cage group,the ROM in all directions of postoperation was significantly lower than that of preoperation(P<0.05). The postoperative ROM of all directions was significantly lower in SMPU cage group and PEEK cage group than autoge-nous iliac bone group(P<0.05). There was no observed statistical difference in the postoperative ROM of all directions between SMPU cage group and PEEK cage group(P>0.05). In axial compression testing,the failure load of PEEK cage group was significantly higher than that of SMPU cage group and autogenous iliac bone group(P=0.000),and the failure load of SMPU cage group was significantly higher than that of autogenous iliac bone group(P=0.000). Conclusion:SMPU cage can meet initial stability and bear the lumbar physiological load for lumbar interbody fusion.
腰椎形状记忆聚氨酯椎间融合器生物力学
lumbar spineshape memory polyurethaneinterbody fusion cagebiomechanics
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