CAJ | 학술논문

目的：通过生物力学测试研究腰椎间盘纤维环切口不同修复方法的生物力学强度。方法：选取小牛腰椎标本制成50个脊柱功能节段，每个节段均在纤维环上作一10mm横切口。按照不同修复方法随机平均分为5组：粘合剂组（A组，选用DermaBond粘合切口）、简单缝合组（B组，采用常规U型缝合法处理切口）、MPSS组（C组，采用改良荷包缝合法处理切口）、粘合剂+简单缝合组（D组）及粘合剂+MPSS组（E组），然后进行纤维环抗静水压强度测试及疲劳测试，根据各组的泄露压力和极限转数来评价其修复效果。结果：A～E组的泄露压力分别为（0.76±0.11）MPa、（1.66±0.11）MPa、（1.84±0.15）MPa、（1.88±0.13）MPa、（2.16±0.24）MPa。 E组泄露压力明显高于其他组，差异有显著性（P＜0.05）。在疲劳测试中，从A～E组各组最后的极限转数分别为（4.42±0.59）万次、（8.06±0.75）万次、（8.44±1.01）万次、（9.76±0.23）万次、（9.88±0.21）万次。 E组与D组比较差异无显著性（P＞0.05），与其他各组比较差异均有统计学意义（P＜0.05）。结论：应用粘合剂+改良荷包缝合法处理纤维环切口，具有较高的生物力学强度。
목적：통과생물역학측시연구요추간반섬유배절구불동수복방법적생물역학강도。방법：선취소우요추표본제성50개척주공능절단，매개절단균재섬유배상작일10mm횡절구。안조불동수복방법수궤평균분위5조：점합제조（A조，선용DermaBond점합절구）、간단봉합조（B조，채용상규U형봉합법처리절구）、MPSS조（C조，채용개량하포봉합법처리절구）、점합제+간단봉합조（D조）급점합제+MPSS조（E조），연후진행섬유배항정수압강도측시급피로측시，근거각조적설로압력화겁한전수래평개기수복효과。결과：A～E조적설로압력분별위（0.76±0.11）MPa、（1.66±0.11）MPa、（1.84±0.15）MPa、（1.88±0.13）MPa、（2.16±0.24）MPa。 E조설로압력명현고우기타조，차이유현저성（P＜0.05）。재피로측시중，종A～E조각조최후적겁한전수분별위（4.42±0.59）만차、（8.06±0.75）만차、（8.44±1.01）만차、（9.76±0.23）만차、（9.88±0.21）만차。 E조여D조비교차이무현저성（P＞0.05），여기타각조비교차이균유통계학의의（P＜0.05）。결론：응용점합제+개량하포봉합법처리섬유배절구，구유교고적생물역학강도。
Objectives: To evaluate the efficacy of different techniques of repairing annulus fibrosus through biomechanical testing method. Methods: 50 lumbar spinal segments were obtained from calves, and one 10mm incision was made in each segment. Segments were randomly assigned into 5 groups according to their respective anulus closure methods: cyanoacrylate glue(group A, DermaBond), simple suture(group B, "U" su-ture), MPSS suture (group C, modified purse-string suture), cyanoacrylate glue+simple suture (group D) and cyanoacrylate glue+MPSS suture (group E). Quantitative discomanometry and cyclic fatigue loading were then applied to compare their leakage pressure and loading cycles, as well as the parameter of disk integrity. Re-sults: The leakage pressure in group A-E was 0.76 ±0.11MPa, 1.66 ±0.11MPa, 1.84 ±0.15MPa, 1.88 ±0.13MPa and 2.16±0.24MPa respectively, group E was significantly higher than the other groups(P<0.05). The number loading cycles in group A-E was 4.42±0.59, 8.06±0.75, 8.44±1.01, 9.76±0.23 and 9.88±0.21 ten thousand times respectively, except for group D, the difference between group E and the other groups was significant (P<0.05). Conclusions: Closing the anulus incision with suture or fibrin glue alone may not be appropriate, the best method is cyanoacrylate glue with MPSS suture.