發(fā)布時(shí)間：2018-05-27 20:53

  本文選題：生物力學(xué) + 椎間盤退化��； 參考：《中國(guó)組織工程研究》2017年31期

【摘要】：背景:腰椎退行性病變是腰椎自然老化、退化的生理病理過(guò)程,嚴(yán)重影響著患者的生活質(zhì)量。傳統(tǒng)的手術(shù)方式會(huì)帶來(lái)一些并發(fā)癥,棘突間動(dòng)態(tài)固定Coflex臨床效果不錯(cuò),但是缺乏實(shí)驗(yàn)數(shù)據(jù)的支持。目的:研究腰椎穩(wěn)定方式對(duì)其運(yùn)動(dòng)影響,從生物力學(xué)角度為臨床手術(shù)提出參考意見(jiàn)。方法:選取新鮮的豬腰椎制備實(shí)驗(yàn)?zāi)Ｐ?組:分別為正常狀態(tài)(A組)、損傷狀態(tài)(B組)、L_3-L_4Coflex固定(C組)、L_3-L_4Coflex固定+減壓(D組)、L_3-L_4椎間融合固定(E組)。運(yùn)用機(jī)器人手臂系統(tǒng)對(duì)每具標(biāo)本5種模型進(jìn)行前屈/后伸、左/右側(cè)彎、左/右軸向旋轉(zhuǎn)6個(gè)方向的生物力學(xué)加載;通過(guò)多方向力矩傳感器采集加載力矩,配合三維動(dòng)作捕捉系統(tǒng)記錄手術(shù)節(jié)段及整體腰椎的運(yùn)動(dòng)范圍,分析穩(wěn)定方式對(duì)腰椎運(yùn)動(dòng)的影響。結(jié)果與結(jié)論:(1)4個(gè)實(shí)驗(yàn)組(B、C、D、E)中,腰椎手術(shù)節(jié)段(L_3-L_4)的三維角度變化范圍與正常狀態(tài)相比,Coflex固定組與正常狀態(tài)組間差異較小,而損傷狀態(tài)組、融合組與正常狀態(tài)組差異較大;(2)融合組雖然可以恢復(fù)損傷后的腰椎活動(dòng)度,但其活動(dòng)角度與Coflex固定組相比小了很多;(3)結(jié)果表明,Coflex固定后可以將損傷狀態(tài)的活動(dòng)角度恢復(fù)到正常狀態(tài),維持腰椎穩(wěn)定性的同時(shí),還保留了一定的活動(dòng)度。腰椎失穩(wěn)后用Coflex彈性內(nèi)固定較融合固定更好,固定后性能更接近正常腰椎。
[Abstract]:Background: lumbar degenerative disease is a natural aging and degenerative physiological and pathological process of lumbar vertebrae, which seriously affects the quality of life of patients. Traditional surgical methods can bring some complications, dynamic interspinous process fixation Coflex clinical effect is good, but the lack of experimental data support. Objective: to study the effect of lumbar stabilization mode on its motion, and to provide reference for clinical operation from biomechanical point of view. Methods: five experimental models of fresh porcine lumbar vertebrae were selected: normal group A, injury group B group L3-L4Coflex fixed and C group L3-L4Coflex fixed and D group L3-L4Coflex fixed decompression and D group L3-L4 intervertebral fusion fixation and fixation E group. The robot arm system is used to carry out the biomechanical loading in 6 directions of forward flexion / extension, left / right bending, left / right axial rotation to each specimen, and the loading moment is collected by multi-direction torque sensor. The motion range of the whole lumbar vertebrae and the operation segment were recorded with 3D motion capture system to analyze the influence of the stabilization mode on the lumbar vertebrae motion. Results and conclusion in the four experimental groups, the range of three dimensional angle changes of L3-L4) in the four experimental groups was smaller than that in the normal group and the Coflex fixation group, but the injury state group. The results showed that there was no significant difference between the Coflex fixation group and the normal group, but there was no significant difference between the Coflex fixation group and the normal group in the L3-L4). Although the fusion group can recover the lumbar vertebrae motion after injury, there is a great difference between the fusion group and the normal state group. But its activity angle was much smaller than that of Coflex fixation group. The results showed that Coflex fixation could restore the activity angle of injured state to normal state, maintain the stability of lumbar vertebrae, and at the same time retain a certain range of motion. Coflex elastic internal fixation is better than fusion fixation after lumbar instability, and its performance is closer to that of normal lumbar spine.
【作者單位】： 首都醫(yī)科大學(xué)生物醫(yī)學(xué)工程學(xué)院;首都醫(yī)科大學(xué)臨床生物力學(xué)應(yīng)用基礎(chǔ)研究北京市重點(diǎn)實(shí)驗(yàn)室;中國(guó)醫(yī)學(xué)科學(xué)院阜外醫(yī)院;首都醫(yī)科大學(xué)附屬北京地壇醫(yī)院骨外科學(xué)系;
【基金】：北京市教育委員會(huì)科技發(fā)展計(jì)劃面上項(xiàng)目(KM201410025012) 首都醫(yī)科大學(xué)基礎(chǔ)臨床合作重點(diǎn)項(xiàng)目(16JL08)~~
【分類號(hào)】：R687
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本文編號(hào)：1943708