目的:比较3种不同类型的后路腰椎椎间融合器的生物力学稳定性.方法:采用8具人尸体新鲜腰椎3,4节段标本,模拟后路双侧植入3种椎间融合器.实验分4组7个状态:①对照组(完整标本,Intact).②螺纹状融合器组(Interfix).③空心箱形融合器组(SynCage).④实心箱形融合器组(Prospace).后3组再分别固定椎弓螺钉钢板.随机安排每个标本的融合器植入顺序.在脊柱三维运动试验机上测试不同状态的三维六个方向上的运动范围.结果:3种不同融合器的前屈运动范围分别为完整状态的77%,66%和67%(按Interfix,Prospace,SynCage的顺序,下同);与完整状态相比具有统计学差异(P＜0.01);不同种融合器之间则无明显差异(P＜0.17).各融合器组的后伸运动的ROM分别为完整状态的99%,79%和90%;完整状态组和各融合器组以及各融合器之间均无明显差异(P=0.25).侧屈方向,各组融合器的植人均明显降低提高了稳定性(P＜0.01),ROM值为相应完整状态的83%,78%,70%;各组融合器之间未表现有明显差异(P=0.15).不同融合器组的旋转运动的ROM均明显增加(P＜0.01),分别较完整状态上升了30%,45%,40%;同时Interfix组与其他2组融合器之间也有统计学差别(P＜0.01),Prospace和SynCage之间则无明显区别(P=0.58).后路固定椎弓螺钉钢板后,腰椎各向ROM值均较单纯的融合器固定组显著降低(P＜0.01).结论:3种融合器之间在除外旋转运动的所有方向的稳定性无统计学差异.单独运用3种椎间融合器均无法在所有方向上达到与完整节段一致的生物力学稳定性,结合使用后路椎弓螺钉钢板后腰椎节段的稳定性可明显提高.%AIM: To compare the biomechanical stability of three different posterior lumbar interbody spinal fusion cages.METHODS: Eight fresh human cadaver lumbar spinal specimens (L3-4)were designed by simnlating posterior implantation of three different cage group (SynCage), and 4 solid rectangle cage group (Prospace). Posterior transpedicular screw plate system was fixed in the latter three cage groups. The implantation sequences of fusion cages were randomly arranged in every specimen. The range of motion(ROM) on six directions under different conditions was tested by spinal three-dimensional analysis system.RESULTS: The ROM of anteflexion of three different cages, Interfix,Prospace and SynCage, were 77%, 66% and 67% of the Intact respectively,which had statistical significances in the comparisons( P ＜ 0.01); and there were no significant differences among different cages( P = 0. 17) . The ROM of extension of there different cages was 99%, 79% and 90% respectively (the same sequence as above) of the Intact. And there were no significant differences among four groups ( P = 0. 25) . The ROM of lateral bending of three different cages decreased, which were 83%, 78%, and 70% respectively(same sequence as above) of the Intact, and the stability significantly increased( P ＜ 0.01), and there were significant differences among three cage group ( P = 0. 15 ). The ROM of axial rotation of different cages significantly increased( P ＜ 0. 01), which increased 30%, 45% and 40% respectively(the same sequence as above) of Intact, and there were also significances between Interfix group and other two cage group( P ＜ 0. 01 ), but there was no significant difference between Prospace and Syncage group ( P = 0. 58). After the fixation of posterior transpedicular screw plate system in three cages groups, each ROM value of lumbar vertebra significantly decreased( P ＜ 0.01 ).
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