【作者】 胡孔和；

【导师】 靳安民；

【作者基本信息】 第一军医大学 ， 骨外科学， 2004， 硕士

【摘要】 目的 欲制备生物可降解的颈椎融合材料，我们合成了羟基磷灰石及左旋聚乳酸复合物（HA／PLLA），将其合成高强度的颈椎椎间融合器，该复合材料有着良好的生物相容性，其材料的生物力学测试得到了较好的结果，抗压强度可达到人体皮质骨水平，为进一步将该生物可吸收的生物活性颈椎椎间融合器（BCFC）推向临床，本实验在成人新鲜颈椎标本上模拟临床术式放置此生物活性颈椎椎间融合器，通过脊柱三维运动稳定性及拔出实验评价其重建颈椎稳定性的效果及植入后的即刻稳定性。 方法 1、在6具新鲜成人颈椎标本，对C_5，6行椎间盘切除术，分别将髂骨、BCFC置于椎间隙及BCFC加钢板，对节段进行脊柱三维运动稳定性评价。 2、在6具新鲜成人颈椎标本，对C_4，5行椎间盘切除术后，分别将BCFC、髂骨置于椎间隙，对植入物进行拔出力学测试。围均增大，但差异无统计学意义在左/右轴向旋转状态下BCFC稳定性增加，计学意义; 在前屈、范围均减少，差异有统计学意义组比骼骨组的运动范围减少，;与正常组运动范围的差异无统左/右侧弯状态下BCFC差异有统计学意义。组比正常组及骼骨组的运动结论翠洲醚箭矍淤巡溯:i沪云了们科。更多还原

【Abstract】 ObjectiveIn our recent study, we have already syntheses HA granules of high purity and crystallinity with osteoinductive characteristics, and poly-L-lactide (PLLA), alse biocompatible and bioresorbable, becoming an optimal osteoinductive composite . Adjusting the conditions for HA and PLLA synthesis, constituent composite can be obtained suitable for application to human organisms as implants of cervical spinal fusion cage. The purpose was to develop the use of BCFC in clinic. In this article, In fresh six human cervical spine specimens, imitative surgical procedures were carried out and BCFC was inserted respectively in the intervertebral spaces. Pull-out tests of the implanted material (C4, 5) and three dimensional spinal stability evaluation (C5, 6) were performed. To evaluate the immediate effects and initial stability imparted to the human cadaveric spine by the newly designed and developed BCFC.Methods1.In six fresh human cervical spine specimens, resection of the C5,6 intervertebral discs were done and iliac crest bone ,BCFC,plate on BCFC were inserted respectively in the intervertebral space. Segemental three dimensional spinal stability (C5 , 6) wereevaluated .2.In six fresh human cervical spine specimens, resection of the C4,5 intervertebral discs were done and BCFC, iliac crest bone were inserted respectively in the intervertebral space. Segemental pull-out tests of the implanted material (C4,5) were performed.Results1.After discectomy, spines receiving the plate on BCFC exhibited an decrease in angular motion in all directions and a significant increase in stability in all directions(p<0.005).2.In extension, both BCFC and iliac crest bone were associated with a decrease in stability than the intact spine, but it was not significantly.3.In left and right axial rotation, BCFC exhibited an decrease in angular motion than iliac crest bone and a significant increase in stability (p<0.005); but it was not significantly than the intact spine.4.In flexion and left/right axial rotation, BCFC exhibited an decrease in angular motion than iliac crest bone and intact, and a significant increase in stability (p<0.005).ConclusionBioactive Cervical Fusion Cage is biodegradable, biocompatible material. BCFC could provide enough support, anti-slide ability and could remain or increase the height of intervertebral spaces. It completely meets clinical and biomechanical requirements. It is worth further medical researchand surgical application in spinal surgery.更多还原