稳定脊柱前柱的一种新型复合装置

A NEW COMBINED IMPLANT FOR VENTRAL STABILIZATION OF SPINE

广泛应用的脊柱前柱固定方法均有不足之处，特别是对神经弓有缺陷的病人。实验研究（１８只犬）和临床实验（２４个病人）表明，ＢＯＰ－Ｂ是一种很好的塑性材料，用以固定脊柱前柱可缩短手术时间，减少手术创伤。该材料有良好的生物结合性能，类似于骨组织。该材料不足之处是，在骨形成的头一个月，矫正畸形可有部分丢失。１９８８年以来，以多孔镍钛植入物治疗２９位病人，并取得改善。该材料的生物力学特性类似于骨组织，即使在没有固定的情况下，畸形矫正再丢失也极少。１９９３年，６位病人手术时用了一种新型复合植入物。该植入物由多孔镍钛和ＢＯＰ－Ｂ组成兼具两者的特性。在骨形成阶段，多孔镍钛对ＢＯＰ－Ｂ有支持作用。ＢＯＰ－Ｂ既能引导骨长入，又能起复合固定作用。以这种新型复合植入物固定不仅可允许病人术后立即活动锻炼，而且允许进行对照检查，包括作ＭＲＩ检查也不会出现伪影。该植入物已成功地用于颈段和胸腰段脊柱的固定。

Widespread methods of ventral stabilization of spine have some insufficiencies,particularty in patients with reurological deficit.From our point of view, Biocompatible Osteoconductive Polymer Block (BOP-B)is a good plastic material.It allows to reduce the operation time and to decrease intraoperative trauma.Experimental studies(18 dogs)and clinical experience(24 patients)have shown a high degree of biointegration of this material which can be compared with original bone.Partial loss of deformity correction during the first, months of bone block formation is an insufficiency of this material.Since 1988, 29 patients have been treated with porous TiNi implants,developed in our clinic.Biomechanical characteristics of this material are comparable to those of bone tissue.Loss of deformity correction was minimal, even without external immobilization.In 1993,6 patients have been operated on with the use of a new combined implant,which consists of porous TiNi and BOP-B, and has properties of both these materials.Porous TiNi supports BOP-B during the period of bony block formation.BOP-B,being a bony conductor, at the same time plays the role of a combined implant fixator. The combind implant allows to mobilize a patient immediately after operation,and to conduct all control examinations, including MRI without artifacts.This implant has been successfully used for the stabilization of cervical and thoracolumbar spine.