Gu Yu-tong, Jia Lian-shun, Chen Tong-yi, Qi Jin, Wang Jun, Cui Shu-fang, Li Xiao-hui
Department of Orthopaedics, Zhongshan Hospital of Fudan University, Shanghai 200032, China.
Zhonghua Wai Ke Za Zhi. 2006 Aug 15;44(16):1127-31.
To compare the characteristics of interbody fusion achieved using hat type cervical intervertebral fusion cage (HCIFC) with those of an autologous tricortical iliac crest graft, Harms cage and Carbon cage in a goat cervical spine model.
Thirty-two goats underwent C(3, 4) discectomy and fusion in which the following were used: Group 1, autologous tricortical iliac crest bone graft (8 goats); Group 2, Harms cage filled with autologous iliac crest graft (8 goats); Group 3, Carbon cage filled with autologous iliac bone (8 goats); Group 4, HCIFC filled with autologous iliac graft (8 goats). Radiography was performed pre- and postoperatively and after 1, 2, 4, 8, and 12 weeks. At the same time points, disc space height, intervertebral angle, and lordosis angle were measured. After 12 weeks, the goats were killed and fusion sites were harvested. Biomechanical testing was performed in flexion, extension, axial rotation, and lateral bending to determine the stiffness and range of motion. All cervical fusion specimens underwent histomorphological analysis.
One week after operation, the DSH, IVA and LA of HCIFC and Carbon cage were statistically greater than those of autologous iliac bone graft and Harms cage. Significantly higher values for disc space height, intervertebral angle and lordosis angle were shown in cage-treated goats than in those that received bone graft over a 12-week period. The stiffness of Harms cage in axial rotation and later bending were statistically greater than that of other groups. Radiographic and histomorphologic evaluation showed better fusion results in cage groups than in autologous bone group.
HCIFC can provide a good intervertebral distractability and enough biomechanical stability for cervical fusion.
在山羊颈椎模型中,比较使用帽式颈椎椎间融合器(HCIFC)与自体三面皮质髂嵴骨移植、哈姆斯融合器和碳素融合器实现椎间融合的特征。
32只山羊接受C(3,4)椎间盘切除术及融合术,使用以下方法:第1组,自体三面皮质髂嵴骨移植(8只山羊);第2组,填充自体髂嵴骨移植的哈姆斯融合器(8只山羊);第3组,填充自体髂骨的碳素融合器(8只山羊);第4组,填充自体髂骨移植的HCIFC(8只山羊)。在术前、术后以及术后1、2、4、8和12周进行X线摄影。在相同时间点,测量椎间隙高度、椎间角度和前凸角度。12周后,处死山羊并获取融合部位。进行前屈、后伸、轴向旋转和侧方弯曲的生物力学测试,以确定刚度和活动范围。所有颈椎融合标本均进行组织形态学分析。
术后1周,HCIFC和碳素融合器的椎间隙高度、椎间角度和前凸角度在统计学上大于自体髂骨移植和哈姆斯融合器。在12周的时间里,使用融合器治疗的山羊的椎间隙高度、椎间角度和前凸角度值显著高于接受骨移植的山羊。哈姆斯融合器在轴向旋转和侧方弯曲时的刚度在统计学上大于其他组。X线摄影和组织形态学评估显示,融合器组的融合结果优于自体骨组。
HCIFC可为颈椎融合提供良好的椎间撑开能力和足够的生物力学稳定性。