仿真人工椎间盘植入羊动物体内的可行性评价

发布时间：2018-05-27 05:03

本文选题：内固定器 + 人工椎间盘　；参考：《天津医科大学》2015年硕士论文

【摘要】：目的:根据设计的非融合技术人工椎体(Artificial Vertebral Body of Non-Fusion Technology,AVBNFT),设计新型仿真人工椎间盘,通过建立仿真人工椎间盘的山羊体内模型,研究假体的喷钛涂层骨组织长入、假体固定效果及是否达到非融合技术,为假体改进提供参考,临床应用提供可行性证据。方法:采用钴铬钼合金、喷钛涂层、硅胶人工间盘设计新型非融合技术人工椎体,根据相同材料,设计仿真人工椎间盘,选择10只成年健康山羊作为实验对象,体重35kg~55kg,均为雄性,羊龄10月~24月,随机分成A、B两组,每组各5只,经腹膜后腰椎前外侧入路,行仿真人工椎间盘的椎间盘置换术,A、B组分别在术后3月、6月行腰椎正侧位的影像学检查,并分别在术后3月、6月取出包括假体在内的周围骨组织和软组织,常规制作标本后分别行病理、扫描电子显微镜检查。通过腰椎正侧位影像学、病理结果及扫描电子显微镜结果评价假体的固定效果、喷钛涂层骨组织长入结果及人工椎间盘的活动度。结果:实验中10只山羊均建模成功,术后无双下肢瘫痪等并发症,术后第1天均可正常活动,双下肢感觉、运动正常,达到了椎间盘置换后的即刻稳定性。术后3月、6月行腰椎正侧位片示假体位置良好,无松动移位。术后3月、6月分别取出假体及周围组织的病理结果及扫描电镜下可见假体喷钛涂层有骨组织长入良好,人工椎间盘的钴铬钼合金、硅胶及喷钛涂层与周围组织相容性良好。在腰椎正侧位、左右侧屈正位、过伸过屈侧位的X线平片,应用Auto CAD制图软件分别测量假体上下终板切线的夹角,显示人工椎间盘有一定的活动度。结论:仿真人工椎间盘的托板喷钛涂层骨长入良好,与椎体的固定效果可靠,材料的生物相容性好,具有非融合技术的效果。
[Abstract]:Objective: to design a new artificial intervertebral disc based on the designed artificial Vertebral Body of Non-Fusion technology AVBNFT, and to study the titanium coated bone tissue growth of the prosthesis by establishing a goat model of artificial intervertebral disc. The effect of prosthesis fixation and the non-fusion technology can provide reference for the improvement of prosthesis and provide the feasible evidence for clinical application. Methods: a new type of artificial vertebral body was designed by using cobalt chromium-molybdenum alloy, titanium coating and silica gel artificial disc. According to the same material, artificial intervertebral disc was designed and 10 adult healthy goats were selected as experimental objects. The body weight was 35 kg to 55 kg, all male, aged from October to 24 months. The sheep were randomly divided into two groups: group A (n = 5) and group A (n = 5), via retroperitoneal anterolateral approach of lumbar vertebrae. The anterior and lateral lumbar vertebrae were examined in group A (3 and 6 months after operation), and the surrounding bone and soft tissue including prosthesis were removed at 3 and 6 months after operation. The specimens were made by pathology and scanning electron microscope. The effects of prosthesis fixation, the growth of bone tissue and the movement of artificial intervertebral disc were evaluated by the imaging, pathological and scanning electron microscopy of the lumbar vertebrae in the anteroposterior and lateral position. Results: all of the 10 goats were successfully modeled, and there were no complications such as paralysis of lower extremities after operation. On the first day of operation, normal movement and sensation of both lower limbs were achieved, and the immediate stability of intervertebral disc replacement was achieved. 3 months after operation, 6 months after operation, the lumbar vertebrae anterior and lateral radiographs showed that the prosthesis was in good position without loosening and displacement. The histopathological results of the prosthesis and its surrounding tissues were taken out at 3 months and 6 months after operation. The results of scanning electron microscope showed that the titanium coating of the prosthesis had good bone tissue growth, and the cobalt, chromium and molybdenum alloy, silica gel and coating coated with titanium spray on artificial intervertebral disc had good compatibility with the surrounding tissues. The angle between the upper and lower end plate of the prosthesis was measured by Auto CAD software, and the movement of the artificial intervertebral disc was showed. The X ray plain film of the lumbar vertebrae in the anteroposterior position, the left and right lateral flexion position and the overstretched lateral position were measured by Auto CAD software. Conclusion: the titanium coated bone with imitated artificial intervertebral disc has good effect of fixation with vertebral body, good biocompatibility and non-fusion technology.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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