CAJ | 학술논문

目的评价侧路单枚椎间融合器融合术式的稳定性及力学合理性。方法建立L4、L5侧路与后路单枚椎间融合器融合术式的三维有限元模型及小牛脊柱模型，测定二者于各种载荷时有关节点的位移，并行统计学分析。结果三维有限元模型分析显示，于腰椎屈曲、后伸、右侧弯及旋转等功况下侧路单枚椎间融合器模型的稳定性均较后路单枚椎间融合器模型高（ P＜0.05）。小牛脊柱模型力学测试也显示，于腰椎屈曲、后伸、左右侧弯及旋转等功况下侧路单枚椎间融合器模型的刚度均较后路单枚椎间融合器模型高（ P＜0.001）。结论侧路植入单枚椎间融合器融合术式不使用椎弓根内固定系统而又能够提供足够的术后即刻稳定性，从生物力学角度看，该术式比后路术式更具优势，为一种合理有效的腰椎椎体间融合术式。
목적평개측로단매추간융합기융합술식적은정성급역학합이성。방법건립L4、L5측로여후로단매추간융합기융합술식적삼유유한원모형급소우척주모형，측정이자우각충재하시유관절점적위이，병행통계학분석。결과삼유유한원모형분석현시，우요추굴곡、후신、우측만급선전등공황하측로단매추간융합기모형적은정성균교후로단매추간융합기모형고（ P＜0.05）。소우척주모형역학측시야현시，우요추굴곡、후신、좌우측만급선전등공황하측로단매추간융합기모형적강도균교후로단매추간융합기모형고（ P＜0.001）。결론측로식입단매추간융합기융합술식불사용추궁근내고정계통이우능구제공족구적술후즉각은정성，종생물역학각도간，해술식비후로술식경구우세，위일충합리유효적요추추체간융합술식。
Objective To investigate the biomechanical and the rationality of mechanics stability of intervertebral fusion through lateral approach .Methods Three‐dimension finite element models and calf lumbamodels of L4 ,L5 intervertebral fusion with one TFC inserted by lateral approach and with one TFC inserted by posterolateral approach were established .Nondestruc‐tive tests were performed .The values were analyzed with SSPS software . Results The analysis of three‐dimension finite ele‐ment model showed that the model had a significantly higher stability than model in the way of escape in extension ,flexion ,right lateral bending and rotation ,especially in rotation load (P<0.05) .The test of calf spine model group showed that the model in sideway had a significantly higher stiffness than the model in the way of escape in flexion ,extension ,right and left lateral ben‐ding (P<0.001) .Conclusion Intervertebral fusion with TFC insertion laterally enables sufficient decompression while it main‐taints a majority of the posterior element of spine ,and ensures better fusion condition .The operation method can take place of intervertebral fusion with TFC insertion posterolaterally .