颈前路多节段椎体次全切除钛笼植入重建颈椎生理弧度的实验研究

Physiological curvature of cervical spine reconstruction using titanium mesh after anterior multilevel corpectomy: an experimental study

目的:研究颈椎前路多节段椎体次全切除减压后两种钛笼植入方法对颈椎生理弧度的影响。方法:选用7具成年防腐尸体颈段标本,术前作为空白对照组;C5、C6椎体次全切除后将钛笼剪成相关长度不预弯植入减压骨槽中作为非预弯组;最后将不预弯钛笼取出,将预弯的钛笼植入相应标本后作为预弯组。3组均拍颈椎标准侧位X线片,测量颈椎弧度、手术节段椎间角度及手术节段椎间高度。结果:钛笼预弯组的颈椎弧度及手术节段椎间角度均较钛笼非预弯组和空白对照组有显著改善(P<0.01);钛笼非预弯组的颈椎弧度及手术节段椎间角度与空白对照组相比无显著性差异(P>0.05);手术节段椎间高度钛笼预弯组与钛笼非预弯组相比无显著性差异(P>0.05),但两组与空白对照组比较有显著性差异(P<0.05)。结论:颈椎前路多节段椎体次全切除减压后钛笼预弯植入可以很好地恢复颈椎的生理弧度。

Objective To study the influence of anterior reconstruction using titanium mesh with two methods on physiological curve of cervical spine after multilevel corpectomy. Methods 7 cervical spine specimens from adult cadaver were harvested. Cervical spine before operation were used as blank contrast group. The non-prebending titanium mesh was inserted into the decompression channel of vertebral bodies after anterior C5, C6 vertebra corpectomy, which were non -prebending group. Finally, the non-prebending titanium mesh was taken out, and then the prebending titanium mesh was inserted into the channel of the vertebral bodies which were prebending group. Radiography of cervical spine were taken in true lateral position in three groups. The curvature of cervical spine, the angle of the fused segment and the height of the fused segment were measured. Results Compared with non-prebending titanium mesh group and blank contrast group ,the curvature of cervical spine and the angle of the fused segment of the prebending titanium mesh group had significant difference（ P 〈 0.01 ）. There was no significant difference in the angle of the fused segment between non-prebending titanium mesh group and blank contrast group（ P 〉 0.05 ）. The height of the fused segment between non-prebending titanium mesh group and prebending titanium mesh group had no significant difference（ P 〉 0.05 ） ; however, there was a significant difference of the height of the fused segment between the both titanium mesh group and blank contrast group. Conclusion The curvature of cervical spine can be well restored using the prebending titanium mesh after anterior multilevel corpectomy.