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仿生人工腰椎及椎间盘复合体的设计及活动度分析
Design and activity analysis of bionic artificial lumbar vertebra and disc complex
  
DOI:
中文关键词:  人工椎体  腰椎  次全切  脊柱肿瘤  脊柱结核
英文关键词:Artificial vertebral body  Lumbar vertebra  Spinal tumor  Spinal tuberculosis
基金项目:
作者单位
刘俭涛 李浩鹏 牛斌斌 李宇欢 高正超 贺西京  
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中文摘要:
      目的 设计一种既能重建腰椎椎体高度又能保留相应椎间隙运动功能的可动腰椎假体用于治疗腰椎肿瘤、结核、骨折等疾病。方法 提取我国60名健康成年男性的腰椎CT数据进行三维重建解剖参数采集,并对解剖数据进行统计学分析,根据统计结果设计仿生人工腰椎及椎间盘复合体,利用3D打印技术制作假体光敏树脂模型并进行活动度评价。结果 椎体前后高度比中间大,上下终板的正中矢状径与冠状径均大于中间水平面,上下终板与侧面呈70余度夹角,同一椎体上下终板凹陷深度存在显著差异(P<0.05)。椎间盘厚度均呈前高> 中高> 后高的规律,前后高度之间具有显著差异(P<0.05)。仿生人工腰椎及椎间盘复合体由椎体部件、椎间盘部件及自攻锁钉螺钉三部分组成。椎体部件侧面设有植骨槽与羟基磷灰石涂层,其可动装置为防脱球窝关节,关节面进行高度抛光处理。假体的构成材料为在临床上被广泛应用的具有良好组织相容性的医用钛合金与高分子复合材料。结论 CT三维重建可以较准确的获得腰椎的解剖参数,理论上仿生人工腰椎及椎间盘复合体可在一定程度上满足腰椎的生理功能,并能通过调整椎间盘部件的大小来改变运动范围,但是该假体的屈服轻度、耐磨、耐腐蚀等性能尚需要体外力学测试及动物体内实验的进一步研究。
英文摘要:
      Objective To design a type of bionic movable prosthesis which can reconstruct the height of lumbar vertebra and preserve the motion of inter-vertebral discs after lumbar subtotal corpectomy for the treatment of the tumor, tuberculosis and fracture of lumbar vertebra. Methods To extract the lumbar CT scan data of 60 healthy male adults of our country for three dimensional reconstruction using Mimics 16.0 and measure the anatomic parameters of lumbar vertebra and inter-vertebral disc. To statistically analyze the anatomic data using IBM SPSS statistics 21and design three dimensional model of bionic artificial lumbar vertebra and disc complex with Solidworks 2013 according the statistical parameters. Then we create a photosensitive resin model of the movable prosthesis with3D-printing technology and make a preliminary assessment of its activity. Results Comparing to anterior and posterior vertebral body height, the middle height of vertebra is smaller. The median saggital and crown diameters of superior and inferior endplates are bigger than those of middle horizontal plane. The angle of upper and lower endplates with profile of lumbar vertebra is about more than 70° and there's no difference among different vertebra(P>0.05). However, the sag depth of superior and inferior endplates exist significant difference(P<0.05).The thickness of inter-vertebral disc obeys the law : anterior height>middle height>posterior height and there is significant difference between anterior and posterior height(P<0.05). Bionic artificial lumbar vertebra and disc complex is composed of three parts : vertebral body parts, inter-vertebral disc parts and screws. The materials of the prosthesis are medical titanium alloys and polymer materials. Its mobile device is anti-extrusion ball-socket joint meeting axial rotation 360°, left or right side bend 10°and flexion or extension15. Conclusion Three-dimensional CT reconstruction can accurately measure anatomic parameters of the lumbar spine. Bionic artificial lumbar vertebra and disc complex can meet lumbar physiological functions to a certain extent, but there is still deficiency of excessive axial rotation and its stability, biocompatibility, corrosion resistance, wear resistance and so on need further study.
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