本文選題：內(nèi)固定器 + 人工椎間盤　； 參考：《天津醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:根據(jù)設(shè)計(jì)的非融合技術(shù)人工椎體(Artificial Vertebral Body of Non-Fusion Technology,AVBNFT),設(shè)計(jì)新型仿真人工椎間盤,通過建立仿真人工椎間盤的山羊體內(nèi)模型,研究假體的噴鈦涂層骨組織長(zhǎng)入、假體固定效果及是否達(dá)到非融合技術(shù),為假體改進(jìn)提供參考,臨床應(yīng)用提供可行性證據(jù)。方法:采用鈷鉻鉬合金、噴鈦涂層、硅膠人工間盤設(shè)計(jì)新型非融合技術(shù)人工椎體,根據(jù)相同材料,設(shè)計(jì)仿真人工椎間盤,選擇10只成年健康山羊作為實(shí)驗(yàn)對(duì)象,體重35kg~55kg,均為雄性,羊齡10月~24月,隨機(jī)分成A、B兩組,每組各5只,經(jīng)腹膜后腰椎前外側(cè)入路,行仿真人工椎間盤的椎間盤置換術(shù),A、B組分別在術(shù)后3月、6月行腰椎正側(cè)位的影像學(xué)檢查,并分別在術(shù)后3月、6月取出包括假體在內(nèi)的周圍骨組織和軟組織,常規(guī)制作標(biāo)本后分別行病理、掃描電子顯微鏡檢查。通過腰椎正側(cè)位影像學(xué)、病理結(jié)果及掃描電子顯微鏡結(jié)果評(píng)價(jià)假體的固定效果、噴鈦涂層骨組織長(zhǎng)入結(jié)果及人工椎間盤的活動(dòng)度。結(jié)果:實(shí)驗(yàn)中10只山羊均建模成功,術(shù)后無雙下肢癱瘓等并發(fā)癥,術(shù)后第1天均可正�；顒�(dòng),雙下肢感覺、運(yùn)動(dòng)正常,達(dá)到了椎間盤置換后的即刻穩(wěn)定性。術(shù)后3月、6月行腰椎正側(cè)位片示假體位置良好,無松動(dòng)移位。術(shù)后3月、6月分別取出假體及周圍組織的病理結(jié)果及掃描電鏡下可見假體噴鈦涂層有骨組織長(zhǎng)入良好,人工椎間盤的鈷鉻鉬合金、硅膠及噴鈦涂層與周圍組織相容性良好。在腰椎正側(cè)位、左右側(cè)屈正位、過伸過屈側(cè)位的X線平片,應(yīng)用Auto CAD制圖軟件分別測(cè)量假體上下終板切線的夾角,顯示人工椎間盤有一定的活動(dòng)度。結(jié)論:仿真人工椎間盤的托板噴鈦涂層骨長(zhǎng)入良好,與椎體的固定效果可靠,材料的生物相容性好,具有非融合技術(shù)的效果。
[Abstract]:Objective: to design a new artificial intervertebral disc based on the designed artificial Vertebral Body of Non-Fusion technology AVBNFT, and to study the titanium coated bone tissue growth of the prosthesis by establishing a goat model of artificial intervertebral disc. The effect of prosthesis fixation and the non-fusion technology can provide reference for the improvement of prosthesis and provide the feasible evidence for clinical application. Methods: a new type of artificial vertebral body was designed by using cobalt chromium-molybdenum alloy, titanium coating and silica gel artificial disc. According to the same material, artificial intervertebral disc was designed and 10 adult healthy goats were selected as experimental objects. The body weight was 35 kg to 55 kg, all male, aged from October to 24 months. The sheep were randomly divided into two groups: group A (n = 5) and group A (n = 5), via retroperitoneal anterolateral approach of lumbar vertebrae. The anterior and lateral lumbar vertebrae were examined in group A (3 and 6 months after operation), and the surrounding bone and soft tissue including prosthesis were removed at 3 and 6 months after operation. The specimens were made by pathology and scanning electron microscope. The effects of prosthesis fixation, the growth of bone tissue and the movement of artificial intervertebral disc were evaluated by the imaging, pathological and scanning electron microscopy of the lumbar vertebrae in the anteroposterior and lateral position. Results: all of the 10 goats were successfully modeled, and there were no complications such as paralysis of lower extremities after operation. On the first day of operation, normal movement and sensation of both lower limbs were achieved, and the immediate stability of intervertebral disc replacement was achieved. 3 months after operation, 6 months after operation, the lumbar vertebrae anterior and lateral radiographs showed that the prosthesis was in good position without loosening and displacement. The histopathological results of the prosthesis and its surrounding tissues were taken out at 3 months and 6 months after operation. The results of scanning electron microscope showed that the titanium coating of the prosthesis had good bone tissue growth, and the cobalt, chromium and molybdenum alloy, silica gel and coating coated with titanium spray on artificial intervertebral disc had good compatibility with the surrounding tissues. The angle between the upper and lower end plate of the prosthesis was measured by Auto CAD software, and the movement of the artificial intervertebral disc was showed. The X ray plain film of the lumbar vertebrae in the anteroposterior position, the left and right lateral flexion position and the overstretched lateral position were measured by Auto CAD software. Conclusion: the titanium coated bone with imitated artificial intervertebral disc has good effect of fixation with vertebral body, good biocompatibility and non-fusion technology.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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本文編號(hào)：1940540