兔腰椎不同融合内固定方式对邻近节段椎间盘的影响及意义探讨

摘要

Objective To study the influence and significance that different fusion and internal fixation methods on adjacent segment disc in rabbit lumbar. Methods 26 adult healthy New Zealand white rabbits were randomly divided into the control group and the observation group (n=13) The control group was received pure anterior lumbar fusion, the observation group was given anterior lumbar spinal fusion and internal fixation. of the of The spine of motion(Range of motion,ROM)of L 2-S 1 and neutral location move(Neutral zone,NZ)in the two groups were compared. Results In 0.4 Nm loads, the adjacent segment L 3-4 bend, stretch ROM respectively was (14.62± 1.84) ° and (6.29±0.94) °, NZ respectively was (5.46±0.81) °and (1.89±0.29) ° in the observation group;while in the control group, the stretch ROM respectively was (13.07±1.69) ° and (5.66±0.71) °, NZ respectively was (4.81±0.80) °(1.68±0.26) °. The differences was statistically significant (P<0.05). Conclusion It can significantly increase the activity of adjacent segment and promote the degeneration of adjacent segment disc that anterior lumbar fusion and internal fixation was used in adiacent segment disc.It should as much as possible reduce or reasonable use the holder to reduce the risk of degeneration in clinic.%目的：探讨兔腰椎不同融合内固定方式对邻近节段椎间盘的影响及其重要意义。方法选取本市南区实验动物养殖场提供的成年健康的新西兰大白兔26只作为实验对象，随机均分为对照组和观察组（n=13），其中对照组采用单纯前路腰椎融合术，观察组选择前路腰椎融合内固定术，比较2组L 2～S 1脊柱标本的上下邻近节段的活动度（Range of motion，ROM）和中性区位移（Neutral zone，NZ）情况。结果在0.4 Nm荷载的情况下，观察组的邻近节段L 3～4的屈、伸ROM分别为（14.62±1.84）°和（6.29±0.94）°，NZ分别为（5.46±0.81）°和（1.89±0.29）°；对照组屈、伸ROM分别为（13.07±1.69）°和（5.66±0.71）°，NZ分别为（4.81±0.80）°和（1.68±0.26）°，2组比较差异具有统计学意义（P＜0.05）。结论给予邻近节段椎间盘前路腰椎融合内固定术治疗，会明显加大邻近节段的活动度，但可促进邻近节段椎间盘退变，临床需要予以足够重视，并通过尽可能减少或合理使用内固定器来降低退变风险。