腰椎椎体间镍钛记忆合金支架的生物力学分析
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上海市科委项目(20S31900800)


Biomechanical Analysis on NiTi Memory Alloy Stent for Lumbar Interbody Fusion
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    摘要:

    目的 测试镍钛记忆合金支架的力学性能及用于腰椎间融合术的体外生物力学性能。 方法 通过力学测试机测试支架的力学性能,并在新鲜腰椎标本上模拟腰椎间融合术,对比分析镍钛记忆合金支架及其配套的骨粒-可吸收骨水泥混凝物浇注植骨方法、传统盒状融合器用于腰椎间融合术的生物力学性能。 结果 镍钛记忆合金支架最大抗压强度为(12 964±962) N,记忆特性有效范围内最大形变为(4. 68±0. 03) mm,形状恢复率为 99. 86% 。 相比于正常腰椎模型,单独使用镍钛记忆合金支架植入模拟腰椎间融合术后手术节段稳定性在前屈、后伸、侧屈、旋转方向上均有增加,与采用传统盒状融合器相当(P>0. 05)。 而在复合使用配套设计的自体骨粒-可吸收骨水泥混凝物植骨后,手术节活动度进一步降低(P<0. 05),节段稳定性与附加椎弓根螺钉内固定组相当(P>0. 05)。 镍钛记忆合金支架植入后的抗拔出强度弱于传统盒状融合器(P<0. 05),在配合使用自体骨粒-可吸收骨水泥混凝物植骨时的抗拔出强度显著强于传统盒状融合器(P<0. 05)。 结论 本研究的镍钛记忆合金支架同时配套设计了相匹配的骨粒-骨水泥混凝物植骨方式,为腰椎间融合术的进一步优化发展提供了新思路。 镍钛记忆合金支架具有良好的支撑及形变性能,用于腰椎间融合术时与传统盒状融合器具有生物力学等效性,在复合应用骨粒-可吸收骨水泥混凝物浇注植骨后能进一步提升稳定性和抗拔出强度。

    Abstract:

    Objective To evaluate biomechanical properties of the nickel-titanium (NiTi) memory alloy stent and its in vitro biomechanical properties for lumbar interbody fusion. Methods The mechanical properties of the NiTi memory alloy stent were tested on mechanical testing machine. Moreover, lumbar interbody fusion was simulated on fresh lumbar specimens, and biomechanical properties of the NiTi memory alloy stent with matching bone graft for used for lumbar interbody fusion were analyzed and compared with the traditional box-shape cage. Results The maximum compressive strength of the NiTi memory alloy stent was ( 12 964 ± 962) N. The maximum deformation within the effective range of memory characteristics was (4. 68±0. 03) mm. The recovery rate of the NiTi memory alloy stent was up to 99. 86% . Compared with the intact lumbar model, the stability of the operative segment after the simulated lumbar interbody fusion using NiTi memory alloy stent alone was increased in the direction of anterior flexion, posterior extension, lateral flexion and rotation, which was equivalent to the boxshape cage group (P>0. 05). After the combined use of autogenous bone granule and absorbable bone cement the ROM of the operative segment was further reduced (P<0. 05), which was equivalent to the box-shape cage+ unilateral posterior fixation group (P>0. 05). The pull-out strength of the NiTi memory alloy stent with matching bone graft group was significantly stronger than that of the box-shape cage group (P<0. 05). Conclusions The NiTi memory alloy stent in this study was designed with a matched bone granule-absorbable bone cement graft,which provided a new idea for the further optimization and development of lumbar interbody fusion. With excellent support and deformation properties, this NiTi memory alloy stent is biomechanical equivalent to the traditional boxshape cage for lumbar interbody fusion, and can greatly improve the stability of surgical segment and the pull-out strength of implants after the combined use of autogenous bone granule and absorbable bone cement.

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黄浩瀚,陈宏方,陈 颜,赵长清.腰椎椎体间镍钛记忆合金支架的生物力学分析[J].医用生物力学,2023,38(2):283-289

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  • 收稿日期:2022-11-28
  • 最后修改日期:2022-12-17
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  • 在线发布日期: 2023-04-25
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