腰椎椎体间镍钛记忆合金支架的生物力学分析
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上海交通大学医学院附属第九人民医院 骨科

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Biomechanical study of a novel NiTi memory alloy frame with matching bone graft 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来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12964±962N,记忆特性有效范围内最大应变为4.68±0.03mm,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,手术节段活动度进一步降低(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(299.98±31.36N)弱于传统盒状融合器(592.84±54.31N)(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(1604.61±92.51 N)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的思路。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 This study aims to evaluate the mechanical and biomechanical properties of the novel NiTi memory alloy frame with matching bone graft for lumbar interbody fusion. Methods The mechanical properties of the NiTi memory alloy frame were tested. Moreover, cadaveric testing was conducted to compare the biomechanical properties between the NiTi memory alloy frame with matching bone graft and the traditional box-shape cage. Results The maximum compressive strength of the NiTi memory alloy frame was 12964±962N. The frame height decreased by 4.68±0.03mm with a recovery rate up to 99.86%. The NiTi memory alloy frame group presented a smaller ROM than did the intact lumbar model group, and no ROM difference compared with the box-shape cage group. Notably, in the models with unilateral/bilateral posterior fixation, the NiTi memory alloy frame with matching bone graft group showed the smallest ROM in vitro flexibility test (P < 0.05). The pull-out strength of the NiTi shape memory alloy frame with matching bone graft group was significantly stronger than that of the box-shape cage group (P < 0.05). NiTi memory alloy frame with matching bone graft method has excellent mechanical properties, and greatly improve the stability of surgical segment and the pullout strength of implants.

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  • 收稿日期:2022-11-28
  • 最后修改日期:2023-01-13
  • 录用日期:2023-01-14
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