山羊新型颈椎间盘置换术后颈椎活动度

Cervical range of motion after novel cervical disc replacement in goats

摘要:

[目的] 测量新型国产人工颈椎间盘假体在山羊颈椎的活动度。[方法] 12 只山羊随机分为 3 组，每组 4 只，包括羟基磷灰石（hydroxyapatite, HA）涂层的间盘假体组，非 HA 涂层的间盘假体组和假手术组。HA 组和非 HA 组动物摘除 C_3/4间盘并置入相应国产人工颈椎间盘假体，假手术组仅行手术显露，未处理椎间盘。动态测量颈椎整体活动度及置换节段活动度 （range of motion, ROM）。[结果]术后动物实验中所有山羊均成活，无切口感染及瘫痪。随时间推移 HA 组和假手术组的 C₂~C₅ ROM 和 C_3/4 ROM 均无显著变化（P＞0.05），而非 HA 组的 C₂~C₅ ROM 和 C_3/4 ROM 显著减少。术前及术后即刻三组间 C₂~C₅ROM 和 C_3/4 ROM 的差异均无统计学意义（P＞0.05），但术后 1 和 3 个月时，HA 组和假手术组的 C₂~C₅ ROM 和 C_3/4 ROM 均显著大于非 HA 组（P＜0.05），而 HA 组与假手术组的 C₂~C₅ ROM 和 C_3/4 ROM 差异无统计学意义（P＞0.05）。[结论] HA 涂层的新型国产人工颈椎间盘置换术后较好的保持了山羊颈椎的活动度。

Abstract:

[Objective] To measure the cervical range of motion (ROM) after cervical disc replacement with a novel prosthesis made in China in goats. [Methods] Twelve goats were randomly divided into 3 groups, including hydroxyapatite (HA) coated intervertebral prosthesis group, non-HA coated intervertebral prosthesis group and sham operation group, with 4 goats in each group. In the HA group and the nonHA group, C_3/4 disc was removed and the corresponding prosthesis was implanted, while the sham group had surgical exposure performed without intervertebral disc involved. The C₂~C₅ ROM and C_3/4 ROM were measured regularly by dynamic radigraphs. [Results] All goats sur- vived without incision infection and paralysis in any animal after operation. HA group and sham group remained no significant changes in C₂~C₅ ROM and C_3/4 ROM over time (P＞0.05), whereas the non-HA group had C₂~C₅ ROM and C_3/4 ROM significantly reduced over time post- operatively (P＜0.05). Although there were no significant differences in C₂~C₅ ROM and C_3/4 ROM among the 3 groups before and immediately after surgery (P＞0.05), the HA group and the sham group had significantly greater C₂~C₅ ROM and C_3/4 ROM than non-HA group at 1 and 3 months after surgery (P＜0.05). However, there was no significant difference in C₂~C₅ ROM and C_3/4 ROM between HA group and sham group at 1 and 3 months postoperatively (P＞0.05). [Conclusion] This novel HA coated intervertebral disc prosthesis made in China does properly maintain the range of motion of cervical spine in goats.