腰椎融合动物模型的建立及生物力学实验研究

发布时间：2019-02-13 08:41

【摘要】：目的：(1)建立前路椎体间融合(ALIF)，360°融合(360°F)，后外侧融合(PLF)的动物模型。(2)比较三种融合方式动物模型的融合率，组织学特点，放射影像学评估的准确性。(3)利用融合的动物模型研究融合节段的生物力学稳定性，相邻上下节段的生物力学特点。方法：60只新西兰大白兔随机作为手术组，采用自体髂骨移植在L_5—L_6节段分别进行前路椎体间融合(n=15)，后外侧融合(n=15)，360°融合(n=30)。另有12只作为对照组。分别在术后4周，8周，12周处死兔，取标本作组织学检测，影像学评价。以手触测试为金标准，比较X线，，CT在判断融合情况方面的准确性。对标本分别施加屈伸，左右侧弯，左右旋转6个方向的纯力矩，通过与完整标本对照，比较不同融合方式融合节段的稳定性及对邻近节段产生的生物力学影响。结果：以手触测试为金标准，12周时，前路椎体间融合组融合率100.00％(10／10)，后外侧融合组融合率66.67％(8／12)，360°融合组融合率50.00％(6／12)，前路椎体间融合组融合率显著高于后外侧融合组及360°融合组(p＜0.05)，后外侧融合组与360°融合组两组间融合率无统计学差异(p＞0.05)。X线及CT扫描在评估前路椎体间融合时完全一致。后外侧融合组，X线特异度25％，阳性预测值72.73％；CT扫描特异度75.00％，阳性预测值88.89％。360°融合组X线特异度50.00％，阳性
[Abstract]:Objective: (1) to establish an animal model of anterior interbody fusion (ALIF), 360 掳fusion (360 掳F), posterolateral fusion (PLF). (2) to compare the fusion rate and histological characteristics of the three fusion models. (3) using the fusion animal model to study the biomechanical stability of the fusion segment and the biomechanical characteristics of the adjacent upper and lower segments. Methods: 60 New Zealand white rabbits were randomly selected as the operation group. The anterior interbody fusion (nong 15), posterolateral fusion (nong 15), and 360 掳fusion (n 30) were performed with autogenous iliac bone graft in the L_5-L_6 segment. Another 12 were used as control group. The rabbits were sacrificed at 4 weeks, 8 weeks and 12 weeks after operation respectively. The specimens were taken for histological examination and imaging evaluation. The accuracy of X-ray and CT in judging fusion was compared with hand-touch test as gold standard. The specimens were subjected to pure torque in 6 directions of flexion and extension left and right lateral bending and left and right rotation respectively. The stability of fusion segments and the biomechanical effects of different fusion methods on adjacent segments were compared with those of intact specimens. Results: the fusion rate was 100.00% (10 / 10) in anterior interbody fusion group, 66.67% (8 / 12) in posterolateral fusion group, 50.00% (6 / 12) in 360 掳fusion group at 12 weeks. The fusion rate of anterior interbody fusion group was significantly higher than that of posterolateral fusion group and 360 掳fusion group (p < 0.05). There was no significant difference in fusion rate between the posterolateral fusion group and the 360 掳fusion group (p > 0. 05). X line and CT scan). In the posterolateral fusion group, the X-ray specificity was 25%, the positive predictive value was 72.73 and the CT scan specificity was 75.00. The positive predictive value was 88.89.360 掳in the fusion group.
【学位授予单位】：四川大学
【学位级别】：博士
【学位授予年份】：2006
【分类号】：R-332;R318.01

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