CAJ | 학술논문

目的：观察Bryan人工颈椎间盘置换术后假体终板与邻近椎体间的即刻稳定性。方法采集6具青年男性新鲜尸体的颈椎标本，截取C2～T2节段，于C4、C5节段行Bryan人工颈椎间盘置换术。将标本置于MTS-858 Bionix生物力学试验机上，采用放射立体照相测量分析（ RSA）技术分别测量颈椎标本过屈、过伸运动时假体终板与邻近椎体间的相对移位程度及最大移位程度（ MTPM）。结果过屈运动时假体终板与上、下方椎体相对移位程度95％CI分别为0．07～0．15、0．07～0．19 mm，过伸运动时分别为0．06～0．18、0．05～0．18 mm，假体终板与邻近椎体间在前后方、分离和侧方的相对移位程度及MTPM均为±0．2 mm。过屈运动时假体终板与邻近椎体间前后方、分离和侧方分别移位（－0．03±0．04）、（－0．02±0．07）、（0±0．10）mm，过伸运动时分别为（0．02±0．04）、（0．01±0．08）、（0±0．11）mm；各方向移位程度比较，P均＞0．05。过屈、过伸两种运动方式下，假体终板与邻近椎体间前后方、分离和侧方分别移位（－0．004±0．040）、（－0．006±0．080）、（－0．002±0．100） mm， P 均＞0．05。结论 Bryan人工颈椎间盘置换术后即刻行过屈、过伸活动时，假体终板与邻近椎体间的移位程度较小、稳定性高。
목적：관찰Bryan인공경추간반치환술후가체종판여린근추체간적즉각은정성。방법채집6구청년남성신선시체적경추표본，절취C2～T2절단，우C4、C5절단행Bryan인공경추간반치환술。장표본치우MTS-858 Bionix생물역학시험궤상，채용방사입체조상측량분석（ RSA）기술분별측량경추표본과굴、과신운동시가체종판여린근추체간적상대이위정도급최대이위정도（ MTPM）。결과과굴운동시가체종판여상、하방추체상대이위정도95％CI분별위0．07～0．15、0．07～0．19 mm，과신운동시분별위0．06～0．18、0．05～0．18 mm，가체종판여린근추체간재전후방、분리화측방적상대이위정도급MTPM균위±0．2 mm。과굴운동시가체종판여린근추체간전후방、분리화측방분별이위（－0．03±0．04）、（－0．02±0．07）、（0±0．10）mm，과신운동시분별위（0．02±0．04）、（0．01±0．08）、（0±0．11）mm；각방향이위정도비교，P균＞0．05。과굴、과신량충운동방식하，가체종판여린근추체간전후방、분리화측방분별이위（－0．004±0．040）、（－0．006±0．080）、（－0．002±0．100） mm， P 균＞0．05。결론 Bryan인공경추간반치환술후즉각행과굴、과신활동시，가체종판여린근추체간적이위정도교소、은정성고。
Objective To observe the initial stability between prosthetic endplate and adjacent vertebrae after Bryan cervical artificial disc replacement .Methods Using 6 fresh human cadaver cervical specimens , from C2 to T2 .The C4 and C5 motion segments were operated with the procedure of Bryan cervical artificial disc replacement .All the specimens were tested on MTS bionix 858 servo-hydraulic material tester .Radiostereometric analysis ( RSA ) technique was used to dectect the inducible displacement and maximum total point motion ( MTPM) between the Bryan disc and adjacent verte-brae during hyperflexion and hyperextension .Results The 95%CI ( confidence interval ) of inducible displacement be-tween the cranial or caudal vertebrae and adjacent endplate during hyperflexion were 0.07-0.15 and 0.07-0.19 mm.The 95%CI of inducible displacement between the cranial or caudal vertebrae and adjacent endplate during hyperextension were 0.06-0.16 and 0.05-0.18 mm.The displacement in anterior-posterior, lateral movements and segregation and the maxi-mum total point motion between the prosthesis endplate and adjacent vertebral were less than 0.2 mm at both hyperflexion and hyperextension .The inducible displacement between the vertebrae and adjacent endplate during hyperflexion were (-0.03 ±0.04) mm on anterior-posterior, (-0.02 ±0.07) mm on segregation and (0 ±0.10) mm on lateral movement (all P>0.05).The inducible displacement between the vertebrae and adjacent endplate during hyperflexion were (0.02 ± 0.04) mm on anterior-posterior, (0.01 ±0.08) mm on segregation and (0 ±0.11) mm on lateral movement (P>0.05).There was no statistical difference of the inducible displacement of the Bryan disc and adjacent vertebrae between hyperflex -ion and hyperextension movements which were (-0.004 ±0.040) mm on anterior-posterior, (-0.006 ±0.080) mm on segregation and (-0.002 ±0.100) mm on lateral movement (P>0.05).Conclusion The inducible displacement be-tween the Bryan disc and adjacent vertebrae is in an acceptable range and Bryan cervical disc has a good initial stability .