L_(4、5)侧路单枚cage椎间融合术式的生物力学及临床研究

Biomechanical and Clinical Study of L_(4、5) Lateral Lumbar Interbody Fusion Using Single Anatomical Threaded Cage

目的评价L4、5侧路单枚椎间融合器融合术式的稳定性及力学合理性。方法建立L4、5侧路与后路单枚椎间融合器融合术式的三维有限元模型及小牛脊柱模型,测定二者的位移变化。临床随访2003年12月～2006年12月行侧路单枚椎间融合器融合术式33例,评价腰痛改善率。结果实验显示侧路模型的稳定性优于后路模型。临床研究显示手术有效率100%,腰痛改善率93.94%,患者满意率100%。结论侧路植入单枚椎间融合器融合术式是一种微创的术式,不使用椎弓根固定系统而又能够提供足够的术后即刻生物力学刚度,是一种合理有效的腰椎椎间融合术式。

Objective To evaluate the relative stability of L4、5 lateral lumbar interbody fusion using single anatomical threaded cage.Methods Twelve calf spine models and dimensional element models of lateral and posterior approach were established.Pure moment and forces were applied to the top of spinal column.The motion range of all the specimens was measured during the experiment.The improvement rate of lumbar pain in 33 patients who took operation from Dec.2003 to Dec.2006 was evaluated.Results The stability in lateral group was superior to posterior group.The effective rate of operation was 100%.The improvement rate of lumbar pain was 93.94%.The patients’s satisfactory rate was 100%.Conclusion Interbody fusion of L4、5 through lateral approach using single anatomical threaded cage without internal fixation is a mini-invasive operation process.It can provide instant posterior biomechanical stiffness.It is an effective operation process of interbody fusion in lumbar.