两种方法治疗腰椎失稳相关疾病的生物力学比较研究

Biomechanical comparison of two methods applied in the treatment of lumbar unsteadiness associated disease

目的研制一种新的腰椎失稳相关疾病治疗方法：椎体间加压融合法，并与传统的PLIF固定法作生物力学比较研究。方法48具小牛L1-L5脊柱标本，标本随机分成两组（n=24），制成腰椎失稳模型。实验组用椎体间加压融合法固定；对照组用传统的PLIF法固定。分别测试两组脊柱标本5种状态（加压、伸展、前屈、右侧弯、左侧弯）的刚度变化。结果在所有模型测试中，加压、伸展、右侧弯、左侧弯4种状态下经椎体间加压融合法明显比传统的PLIF法标化刚度大（P〈0．05），其中加压、伸展测试的差异最显著（P〈0．01），前屈两者无明显差别（P〉0．05）。椎体间加压融合法在加压、伸展测试的标化刚度分别是传统的PLIF法的1．3～1．4倍。结论椎体间加压融合法比传统PLIF法在治疗腰椎失稳相关疾病方面具有更大的稳定性和应用前景。

Objective To evaluate the biomechanical features of Interbedy Compression Fusion in the treatment of lumbar unsteadiness associated disease. Methods 48 calves lumbar functional spinal units （ L1-L5 ） were divided into two greups. Experimental group was fixated by Interbody Compression Fusion technique; Control group was fixated by traditional PLIF technique. Nondestructive biomechanical tests were performed including central compression, flexion, extension and bilateral bending. Results The stability of experimental group was a significantly higher than that of control group in central compression, extension and bilateral bending（ P 〈 0.05）. The major difference was noted in compression and extension （ P 〈 0.01 ）. There was no significant difference in flexions （ P 〉 0. 05）. The normalized stiffness values of the Interbedy Compression Fusion were 1.3 - 1.4 times higher than the values of the traditional PLIF. Conclusion Interbedy Compression Fusion techniques produced a stiffer construct and better prospect than traditional PLIF techniques in the treatment of lumbar unsteadiness associated disease.