【摘要】：目的：(1)建立前路椎體間融合(ALIF)，360°融合(360°F)，后外側(cè)融合(PLF)的動(dòng)物模型。(2)比較三種融合方式動(dòng)物模型的融合率，組織學(xué)特點(diǎn)，放射影像學(xué)評(píng)估的準(zhǔn)確性。(3)利用融合的動(dòng)物模型研究融合節(jié)段的生物力學(xué)穩(wěn)定性，相鄰上下節(jié)段的生物力學(xué)特點(diǎn)。 方法：60只新西蘭大白兔隨機(jī)作為手術(shù)組，采用自體髂骨移植在L_5—L_6節(jié)段分別進(jìn)行前路椎體間融合(n=15)，后外側(cè)融合(n=15)，360°融合(n=30)。另有12只作為對(duì)照組。分別在術(shù)后4周，8周，12周處死兔，取標(biāo)本作組織學(xué)檢測(cè)，影像學(xué)評(píng)價(jià)。以手觸測(cè)試為金標(biāo)準(zhǔn)，比較X線，，CT在判斷融合情況方面的準(zhǔn)確性。對(duì)標(biāo)本分別施加屈伸，左右側(cè)彎，左右旋轉(zhuǎn)6個(gè)方向的純力矩，通過(guò)與完整標(biāo)本對(duì)照，比較不同融合方式融合節(jié)段的穩(wěn)定性及對(duì)鄰近節(jié)段產(chǎn)生的生物力學(xué)影響。 結(jié)果：以手觸測(cè)試為金標(biāo)準(zhǔn)，12周時(shí)，前路椎體間融合組融合率100.00％(10／10)，后外側(cè)融合組融合率66.67％(8／12)，360°融合組融合率50.00％(6／12)，前路椎體間融合組融合率顯著高于后外側(cè)融合組及360°融合組(p＜0.05)，后外側(cè)融合組與360°融合組兩組間融合率無(wú)統(tǒng)計(jì)學(xué)差異(p＞0.05)。X線及CT掃描在評(píng)估前路椎體間融合時(shí)完全一致。后外側(cè)融合組，X線特異度25％，陽(yáng)性預(yù)測(cè)值72.73％；CT掃描特異度75.00％，陽(yáng)性預(yù)測(cè)值88.89％。360°融合組X線特異度50.00％，陽(yáng)性
[Abstract]:Objective: (1) to establish an animal model of anterior interbody fusion (ALIF), 360 擄fusion (360 擄F), posterolateral fusion (PLF). (2) to compare the fusion rate and histological characteristics of the three fusion models. (3) using the fusion animal model to study the biomechanical stability of the fusion segment and the biomechanical characteristics of the adjacent upper and lower segments. Methods: 60 New Zealand white rabbits were randomly selected as the operation group. The anterior interbody fusion (nong 15), posterolateral fusion (nong 15), and 360 擄fusion (n 30) were performed with autogenous iliac bone graft in the L_5-L_6 segment. Another 12 were used as control group. The rabbits were sacrificed at 4 weeks, 8 weeks and 12 weeks after operation respectively. The specimens were taken for histological examination and imaging evaluation. The accuracy of X-ray and CT in judging fusion was compared with hand-touch test as gold standard. The specimens were subjected to pure torque in 6 directions of flexion and extension left and right lateral bending and left and right rotation respectively. The stability of fusion segments and the biomechanical effects of different fusion methods on adjacent segments were compared with those of intact specimens. Results: the fusion rate was 100.00% (10 / 10) in anterior interbody fusion group, 66.67% (8 / 12) in posterolateral fusion group, 50.00% (6 / 12) in 360 擄fusion group at 12 weeks. The fusion rate of anterior interbody fusion group was significantly higher than that of posterolateral fusion group and 360 擄fusion group (p < 0.05). There was no significant difference in fusion rate between the posterolateral fusion group and the 360 擄fusion group (p > 0. 05). X line and CT scan). In the posterolateral fusion group, the X-ray specificity was 25%, the positive predictive value was 72.73 and the CT scan specificity was 75.00. The positive predictive value was 88.89.360 擄in the fusion group.
【學(xué)位授予單位】：四川大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2006
【分類號(hào)】：R-332;R318.01

【引證文獻(xiàn)】

相關(guān)博士學(xué)位論文 前2條

1 胡志軍;腰椎后路手術(shù)原性多裂肌損傷和萎縮的相關(guān)研究：解剖基礎(chǔ)和因素分析[D];浙江大學(xué);2012年

2 周志杰;腰椎融合術(shù)后鄰近節(jié)段退變的手術(shù)相關(guān)危險(xiǎn)因素分析和早期臨床觀察[D];浙江大學(xué);2012年

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