腰椎间螺纹异体皮质骨融合支架的设计与生物力学测定

Design and Biomechanical Measurement of Allograft Interbody Fusion Cage for Lumbar Spodylolisthesis

目的 :探讨螺纹异体皮质骨椎间融合支架 (allograftinterbodyfusionCageAIFC)腰椎间融合的稳定性与强度。方法 :用 4具新鲜尸体的尺骨、桡骨和腓骨制成AIFC ,同时用环钻取带双面皮质的髂骨行压缩试验 ,并模拟临床切除L2～ 3 ,L4～ 5椎间盘后分别将AIFC和髂骨植入椎间隙行拔出试验。结果 :( 1)最大抗压负荷AIFC组为 ( 82 6 8± 490 3)N ,髂骨组为( 1385± 2 2 3)N ,AIFC组为髂骨组的 6倍 (P <0 .0 1)。 ( 2 )植骨块移位时的最大拔出力AIFC组为 ( 4 89± 2 0 6 )N ,髂骨组 ( 89± 45 )N ,AIFC组是髂骨组的 5 .5倍 (P <0 .0 1)。结论 :AIFC具有足够的支撑、维持或增加椎间隙高度功能 ,椎间稳定性好 ,其设计独特合理 。

Objective: To measure strength and intervertebral stability of using allograft interbody fusion cage(AIFC)for lumbar interbody fusion.Methods:The AIFC were made of ulnar,radius,fibula from 4 individual donors and cylindrical iliac bone were harvested simultaneously with the trephine cutter from iliac crests,the compression tests of the material were performed in vitro.Resection of the L 2～3 and L 4～5 intervertebral discs were done with the trephine cutter to simulate a lumbar surgical procedures,AIFC and iliac bone blocks were inserted respectively in the intervertebral spaces and segment pull out tests were performed.Results:Maximum compressive load and drawing load were 8268±4905N and 498±206N respectively in AIFC group,but these were 1385±223N and 89±45N respectively in the iliac bone group,it was significant greater in AIFC group than in iliac bone group( P <0.01).Conclusion:AIFC could provide enough support,anti slide ability and could remain or increase the height of intervertebral space.The design is distinctive and reasonable.It completely meets biomechanical and clinical requirements.