CAJ | 학술논문

目的研究单纯植入椎间融合器(Cage)进行腰椎前路椎间融合的即刻与疲劳稳定性.方法 6副人腰椎标本(L3-S1),L4以上和S1以下包埋固定,保留L4/L5和L5/S1两个间隙活动.首先作为空白组测试,随后于L5/S1间隙植入Cage作为实验组测试.即刻稳定性测试L4/L5、L5/S1椎体间在前屈、后伸、侧屈3个方向相对活动度.疲劳稳定性测试屈伸5万次后,Cage在L5/S1椎间隙中的相对位移.结果 L5/S1,植入Cage后在前屈、后伸、左侧屈3种运动下,椎间相对活动度分别为(0.83±0.26)°、(1.60±0.19)°和(0.72±0.20)°,明显小于空白组的活动度(3.60±0.30)°、(4.82±0.34)°和(3.80±0.28)°,差异均有统计学意义(均P＜0.01).同时L4/L5椎间相对活动度代偿性增加,分别为(5.82±0.36)°、(5.38±0.30)°和(4.96±0.29)°,明显大于空白组(4.16±0.33)°、(4.02±0.30)°和(3.48±0.34)°,差异均有统计学意义(均P＜0.01).5万次屈伸疲劳运动后,Cage与S1椎体问的相对位置无明显变化,相对位移为0.结论单纯应用Cage进行腰椎前路椎间融合,具有良好的即刻稳定性与疲劳稳定性.
목적 연구단순식입추간융합기(Cage)진행요추전로추간융합적즉각여피로은정성.방법 6부인요추표본(L3-S1),L4이상화S1이하포매고정,보류L4/L5화L5/S1량개간극활동.수선작위공백조측시,수후우L5/S1간극식입Cage작위실험조측시.즉각은정성측시L4/L5、L5/S1추체간재전굴、후신、측굴3개방향상대활동도.피로은정성측시굴신5만차후,Cage재L5/S1추간극중적상대위이.결과 L5/S1,식입Cage후재전굴、후신、좌측굴3충운동하,추간상대활동도분별위(0.83±0.26)°、(1.60±0.19)°화(0.72±0.20)°,명현소우공백조적활동도(3.60±0.30)°、(4.82±0.34)°화(3.80±0.28)°,차이균유통계학의의(균P＜0.01).동시L4/L5추간상대활동도대상성증가,분별위(5.82±0.36)°、(5.38±0.30)°화(4.96±0.29)°,명현대우공백조(4.16±0.33)°、(4.02±0.30)°화(3.48±0.34)°,차이균유통계학의의(균P＜0.01).5만차굴신피로운동후,Cage여S1추체문적상대위치무명현변화,상대위이위0.결론 단순응용Cage진행요추전로추간융합,구유량호적즉각은정성여피로은정성.
Objective To investigate the spinal segment instant and fatigue stability of anterior lumbar interbody fusion with stand-alone cage.Methods The vertebrae L4 and S1 of 6 human lumbar specimens(L3-S1)were embedded with dental base acrylic resin powder and fixed on mechanical machine,and the L4/Ls and L5/S1 disk spaces were left active.The 6 specimens underwent mechanical test as control group first,and then used as experimental group with a cage implanted in L5/S1.Instant instability Was tested in three directions:flexion,extension,and lateral bend.The relative movement of L4/L5 and L5/S1 was recorded.Fatigue instability was tested after 50 000 times of flexion-extension movement,and the relative displacement between the cage and S1 Was recorded.Result In the three directions of flexion,extension,and lateral bend,the relative movements of L5/S1 in the experimental group were 0.83±0.26°,1.60±0.19°,and 0.72±0.20°respectively,all significantly decreased than those of the control group (3.60±0.30°,4.82±0.34°,and 3.80±0.28°respectively,all P＜0.01).The relative movement of L4/L5 of the experimental group were 5.82±0.36°,5.38±0.30°,and 4.96±0.29°in the three directions respectively.all significantly higher than those of the control group(4.16±0.33°,4.02±0.30°,and 3.48±0.34°respectively,all P＜0.01).After 50 000 times of flexion-extension fatigue movement,the relative displacement between the cage and S1 was zero.Conclusion Anterior lumbar interbody fusion with a stand-alone cage has excellent instant and fatigue stability,which can provide enough stability for clinical bone fusion without other internal fixation.