钛网椎管成形植骨脊柱融合的实验研究

A Study of the Rertebral Canal Veconstruction and Spinal Fusion Using Titanic Net

目的 观察以犬作为实验动物,进行钛合金网为支撑物的脊柱椎管重建及植骨融合情况,并探讨其临床可行性。方法对6只蒙古犬进行静脉全麻,暴露T_(10)～L_3椎板,行全椎板减压,用钛丝将“Ω”形钛合金网固定并覆盖于减压区,上填自体骨及异种脱蛋白松质骨,逐层闭合伤口。于术后,6周、12周分别摄手术部位X线正侧位片及CT扫描,对比观察骨质愈合情况,钛网位置及椎管成形情况。同时宰杀3只动物,对实验部位行大体观察。结果 所有伤口均一期愈合。12周X线提示异种骨与钛网融合成片,形成椎板样结构,椎板与异种骨相接处骨质融合。CT扫描示椎管成形良好,硬膜囊未见骨性压迫。结论 应用钛网支撑植骨脊柱后路融合,可以在保护脊髓,神经根免于受压,维持减压效果的同时,有效的进行脊柱后路融合,在临床上有广阔的应用前景。

Objective To study the vertebral canal reconstruction and spinal fusion on the basis of titanic net on dog, and discuss its clinical feasibility. Methods All 6 Mongolia dogs were performed intravenous anesthesia. The vertebral lamina of T10 ~ L3 was exposed and decompressed. 'H' -shape titanic net was placed upon the area of decompression and fixed by titanic wire. The incisions were closed after the autogenic and heterogeneous graft bone placed on the net. Then the X-film and CT were performed at the time of postoperative, 6, 12 weeks. The healing of bone, location of titanic net and reconstruction of vertebral canal were compared, the gross structure was also obsersed by killing three dogs of total. Results All incisions were healed. The X-film showed the heterogeneous graft bone and titanic net grew into the shape of of vertebral lamina. And bony fusion could be found between the vertebral lamina and heterogeneous bone. CT displayed the good reconstruction of vertebral canal and there was no bony compression to the dura mater. Conclusion Spinal fusion with the titanic net can prevent the compression of spinal cord and nerve root, keep the result of decompression and promote the posterior fusion, and own a widely prospect of clinical application.