腰4、5后路三种椎间融合器融合的生物力学实验研究
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摘要
1背景
腰椎退行性病变往往需要手术治疗；手术方法常采用后路减压、椎弓根螺钉固定、间盘切除椎间植骨融合。以往对于脊柱内固定器械的生物力学评价多以模拟脊柱骨折脱位以固定器进行固定，在前屈、后伸、左侧弯、右侧弯、压缩、扭转工况下施加载荷或扭矩，以位移或扭转角的大小来进行稳定性评价。模拟腰椎退变后路椎弓根螺钉固定椎间分别以三种椎间融合器融合的应力遮挡效应等实验研究未见报道。
2目的
模拟腰椎4、5退变后路椎弓根螺钉固定椎间以三种椎间融合器融合后以应变电测量技术和原理、流变特性为基础理论和电子显微镜、图像分析技术等进行应力遮挡效应、内固定器固定部位松质骨密度、骨组织形态计量学指标测量和骨组织形态观察。对三种融合器的融合效果进行系统的、客观的评价。为临床腰椎退变选择合理的术式、合适的固定器械，为新型内固定器械的设计、研制提供生物力学基础。
3方法
3.1标本分组
30个猪胸12-骶1标本随机分为模拟腰4、5退变后路椎弓根螺钉固定椎间植骨组、植骨笼组、植钛网组，每组10个标本。
3.2各组标本应力遮挡效应应变电测量方法
首先对内固定前各组标本进行应变电测量，分别在各组标本椎弓根螺钉固定螺钉孔边缘部位粘贴电阻应变片，在电子万能试验机上模拟人的生理功能在压缩、前屈、后伸、左侧弯、右侧弯载荷作用下进行静态应变电测量，通过动静态电阻应变仪测量各测点的应变值，以单向虎克定律计算各测点的应力值。内固定前各组标本应变电测量完成后，待标本恢复24小时后，去除标本上的应变片；复制腰4、5退变后路椎弓根螺钉固定、椎间分别植骨、植骨笼、植钛网模型；之后在各组标本椎弓根螺钉螺钉孔边缘部位（与标本内固定前粘贴位置相同）粘贴电阻应变片，在电子万能试验机上模拟人的生理功能在压缩、前屈、后伸、左侧弯、右侧弯载荷作用下进行静态应变电测量，通过动静态电阻应变仪测量各测点的应变值，以单向虎克定律计算各测点的应力值。
3.3骨密度测量方法
骨密度测量标本为做完应变电测量实验后的标本。取各组标本固定部位边缘的腰椎松质骨在美国产Norlarid公司XR-600双能X射线骨密度仪上进行骨密度测量。
3.4骨组织学观察方法
取做完应变电测量实验后的各组标本，在固定部位边缘同一部位松质骨取样，进行固定，脱水、不脱钙，硬组织处理，以切片机沿椎体松质骨纵向切片，厚度为8μm，不染色，以德国蔡司公司生产的扫描电子显微镜进行组织学观察。
3.5骨组织形态计量参数测量方法
取做完应变电测量实验后的各组标本，在固定部位边缘同一部位松质骨试样，对试样进行固定、脱钙、包埋之后以切片机切片厚度为5μm，以图像分析系统测量骨小梁表面周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度。
4结果
4.1各组标本应变电测量结果表明：内固定后植骨组标本在压缩、前屈、后伸、左侧弯、右侧弯载荷作用下各测点的应变和应力均大于植骨笼组和植钛网组，差异显著（P<0.05）。内固定后植骨笼组标本在压缩、前屈、后伸、左侧弯、右侧弯载荷作用下各测点的应变和应力均大于植钛网组，差异显著（P<0.05）。
4.2各组骨密度测量结果表明：非固定部位松质骨骨密度大于植钛网组、植骨笼组、植骨组，差异显著（P<0.05）；植钛网组骨密度大于植骨笼组和植骨组，差异显著（P<0.05）；植骨笼组骨密度大于植骨组，差异显著（P<0.05）。
4.3各组松质骨骨组织学观察结果表明：非固定部位对照组松质骨骨小梁细密，纤维结构排列整齐；植钛网组1号测点边缘部位松质骨骨小梁变细、纤维结构排列有一定程度紊乱；植骨笼组1号测点边缘部位松质骨骨小梁多数变细、纤维结构排列紊乱；植骨组1号测点边缘部位松质骨骨小梁大多数变细，纤维结构排列更加紊乱、局部地方有空隙。
4.4骨组织形态计量参数测量结果表明：非固定部位对照组骨小梁表面周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度分别与植钛网组、植骨笼组、植骨组骨小梁表面周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度配对t检验，有统计学意义（P<0.05）。植钛网组骨小梁表面周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度分别与植骨笼组、植骨组骨小梁周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度配对t检验，有统计学意义（P<0.05）。植骨笼组骨小梁周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度与植骨组骨小梁周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度配对t检验，有统计学意义（P<0.05）。
5结论
综合分析各组标本应变电测量结果、骨密度、骨组织形态观察结果、骨组织形态计量参数，可以得出以下结论：
5.1应变电测量结果表明：植钛网组植入物边缘5、6号测点和螺钉孔边缘部位1、2、3、4号测点在压缩、前屈、后伸、左侧弯、右侧弯受力状态下应变和应力小于植骨笼组和植骨组，有统计学意义，说明植钛网组应力遮挡效应最低。植骨笼组植入物边缘5、6号测点和螺钉孔边缘1、2、3、4号测点的应变和应力小于植骨组，有统计学意义，说明植骨笼组应力遮挡效应小于植骨组。椎间植钛网、植骨笼、植骨在外力作用下具有不同的应力遮挡效应。
5.2腰4、5植钛网融合组植入物边缘松质骨的骨密度大于植骨笼组和植骨组，有统计学意义，说明植钛网组在外力作用下，植入物边缘的松质骨的损伤小。
5.3植钛网组骨小梁周长、骨小梁面积、骨量、骨小梁厚度大于植骨笼组和植骨组，骨小梁分离度小于植骨笼组和植骨组，有统计学意义；说明植入不同的融合器对植入物边缘松质骨损伤程度不同，植钛网组损伤最小。
5.4植钛网组在外力作用下，螺钉孔边缘松质骨显微结构改变程度比植骨笼组、植骨组轻。
5.5植入物边缘松质骨的骨密度和应力遮挡效应基本呈负相关，即骨密度越大，应力遮挡效应越低。
5.6植入物边缘松质骨骨小梁周长、骨小梁面积、骨量、骨小梁厚度和植入物植入后应力遮挡效应基本呈正相关关系，骨小梁分离度和植入物植入后的应力集中和应力遮挡效应基本呈负相关关系。
5.7腰4、5退变后路椎弓根螺钉固定椎间植钛网融合在外力作用下，具有应力集中小和应力遮挡效应小的固定效果。
Research background
Lumbar degenerative diseases often require surgical treatment,which include posteriordecompression, pedicle screw fixation,disc removal and intervertebral bone graftfusion.Previous biomechanical researches and evaluation of spinal internal fixation deviceswere to simulate a spinal fracture and dislocation fixed with the fixation devices,then givethem the anteflexion, extension, left side bending,right side bending, compressive, torsiveloading or torque, to evaluate the stability by the displacement or the torsion Angle. There isno research of stress shield by simulation of posterior intervertebral fusion with threeintervertebral fusion devices in lumbar4、5degeneration with posterior pedicle screwfixation
Objective
To simulate posterior intervertebral fusion with three intervertebral fusion devices withposterior pedicle screw fixation of lumbar4、5degeneration,then measure stress shield,cancellous bone density of the fixed vertebral part, do the bone histomorphometry and bonemorphological observation on the basis of strain electrical measuring technology andprinciple, the rheological characteristics theory and with the help of electron microscopy andimage analysis technology and etc. Give an objective and system evaluation to the syncreticeffect of three kinds of intervertebral fusion devices;to provide biomechanical basis for thechoice of reasonable operation, the appropriate fixation devices of lumbar degenerationand new type of fixed equipment design and development.
Methods
3.1group the specimens
The thirty porcine spine specimens with T12to S1were randomly divided into threegroups, posterior intervertebral fusion with bone graft group (bone graft group), posteriorintervertebral fusion with bone cage group (bone cage group), posterior intervertebral fusion with titanium mesh group (titanium mesh group),in simulation of lumbar4、5degenerationwith posterior pedicle screw fixation,each group have10specimens.
3.2strain electrical measuring method of stress shield effect in each group
First measure the strain of each group before internal fixation. To simulate thebiological function of human,give the specimens compressive, anteflexion, extension, leftside bending, right side bending loading, do the strain electrical measurement of every pointof three groups after pastering of electric resistance strain gage by the help of the electronicaluniversal testing machine, calculate stress of every point by the one-way Hook’s Law. Thenmeasure the strain of each group after internal fixation.Remove the electric resistance straingage, give the specimens24hours to recover,simulate the model off posterior intervertebralfusion with three intervertebral fusion devices in lumbar4、5degeneration with posteriorpedicle screw fixation,do the same work as before.
3.3bone density measuring method
After strain electrical measurement of each specimen, measure the bone density byXR-600Dual-energy X-ray bone density instrument produced in America. The cancellousbone is carried from the same fringe of each fixed position of each group.
3.4method of histological observation of the bone
After strain electrical measurement of each specimen, carry cancellous bone from thesame fringe of each fixed position of each group,then fixed, dehydration, non-decalcification,do the section of8μm thickness，then do histological observation of the section by scanningelectron microscope produced by Zeiss company in Germany
3.5measuring method of the cancellous bone histomorphology
After strain electrical measurement of each specimen, carry cancellous bone from thesame fringe of each fixed position of each group,then fixed, decalcification,enbedding,do thesection of5μm thickness，measure the trabecular bone surface perimeter, trabecular bonesurface acreage, bone mass (trabecular bone), the trabecular bone thickness, degree ofseparation of the trabecular bone with the help of the image analysis systemResults
4.1The strain electrical measuring results show that the strain and the stress of the bonegraft group is bigger than the bone cage group and the titanium mesh group under thecompressive, anteflexion, extension, left side bending, right side bending loading at everymeasuring point, which has significant difference (P <0.05),the strain and the stress of thebone cage group is bigger than the titanium mesh group under the compressive, anteflexion, extension, left side bending, right side bending loading at every measuring point, whichhas significant difference (P <0.05).
4.2The measuring results of the bone density show that the bone density of the controllgroup is bigger than the titanium mesh group,the bone cage group and the bone graft group,which has significant difference (P <0.05), the bone density of the titanium mesh group isbigger than the bone cage group and the bone graft group, which has significant difference(P <0.05), the bone density of the bone cage group is bigger than the bone graft group,which has significant difference (P <0.05).
4.3The histological observation of the cancellous bone show that the trabecula of thecontroll group is fine and dense,the structure is in alignment, some of the trabecula of thetitanium mesh group is thinner and the structure have a certain degree disorder, most of thetrabecula of the bone cage group is thinner and the structure is in a mess, almost all of thetrabecula of the bone graft group is thinner and the structure is in a chaos,there is gap in it.
4.4The measuring results of the cancellous bone histomorphology show that thetrabecular bone surface perimeter, trabecular bone surface acreage, bone mass (trabecularbone), the trabecular bone thickness, degree of separation of the trabecular bone of thecontroll group pairs respectively with the titanium group, the bone cage group,the bone graftgroup, the matching t-test has statistical significance (P <0.05). The measuring results of thecancellous bone histomorphology show that the trabecular bone surface perimeter, trabecularbone surface acreage, bone mass (trabecular bone), the trabecular bone thickness, degree ofseparation of the trabecular bone of the titanium mesh group pairs respectively with the bonecage group,the bone graft group, the matching t-test has statistical significance (P <0.05).The measuring results of the cancellous bone histomorphology show that the trabecular bonesurface perimeter, trabecular bone surface acreage, bone mass (trabecular bone), thetrabecular bone thickness, degree of separation of the trabecular bone of the bone cage grouppairs with the bone graft group, the matching t-test has statistical significance (P <0.05).Conclusions
5.1The strain electrical measuring results show that the strain and the stress of thetitanium mesh group is smaller than the bone cage group and the titanium mesh group underthe compressive, anteflexion, extension, left side bending, right side bending loading atevery measuring point, which has significant difference (P <0.05), which illustrate that thestress shield of the titanium mesh group is the lowest. The strain and the stress of the bonecage group is smaller than the bone graft group under the compressive, anteflexion, extension, left side bending, right side bending loading at every measuring point, whichhas significant difference (P <0.05), which illustrate that the stress shield of the bone cagegroup is lower than the bone graft group. The titanium mesh group,the bone cage group andthe bone graft group has different stress shield.
5.2The measuring results of the bone density show that the bone density of the titaniummesh group is bigger than the bone cage group and the bone graft group, which hasstatistical difference (P <0.05), which illustrate the cancellous bone’s injury of the titaniumis smallest under the loading.
5.3The measuring results of the cancellous bone histomorphology show that thetrabecular bone surface perimeter, trabecular bone surface acreage, bone mass (trabecularbone), the trabecular bone thickness, degree of separation of the trabecular bone of thecontroll group pairs respectively with the titanium group, the bone cage group,the bone graftgroup, the matching t-test has statistical significance (P <0.05), which illustrate thecancellous bone’s injury of the titanium is smallest under different loading.
5.4The histological observation of the cancellous bone show that the change of thetrabecula structure in the titanium mesh group is gentle.
5.5The measuring results of the bone density show that the bone density was inverselyassociated with the stress shield effect, the greater of the bone density, the lower of the stressshield effect
5.6The measuring results of the cancellous bone histomorphology show that thetrabecular bone surface perimeter, trabecular bone surface acreage, bone mass (trabecularbone), the trabecular bone thickness and stress shield are positive correlation, degree ofseparation of the trabecular bone and stress shield are negative correlation.
5.7Posterior intervertebral fusion with titanium mesh in lumbar4、5degeneration withposterior pedicle screw fixation has a small stress concentration and stress shield effect.
腰椎退行性病变往往需要手术治疗；手术方法常采用后路减压、椎弓根螺钉固定、间盘切除椎间植骨融合。以往对于脊柱内固定器械的生物力学评价多以模拟脊柱骨折脱位以固定器进行固定，在前屈、后伸、左侧弯、右侧弯、压缩、扭转工况下施加载荷或扭矩，以位移或扭转角的大小来进行稳定性评价。模拟腰椎退变后路椎弓根螺钉固定椎间分别以三种椎间融合器融合的应力遮挡效应等实验研究未见报道。
2目的
模拟腰椎4、5退变后路椎弓根螺钉固定椎间以三种椎间融合器融合后以应变电测量技术和原理、流变特性为基础理论和电子显微镜、图像分析技术等进行应力遮挡效应、内固定器固定部位松质骨密度、骨组织形态计量学指标测量和骨组织形态观察。对三种融合器的融合效果进行系统的、客观的评价。为临床腰椎退变选择合理的术式、合适的固定器械，为新型内固定器械的设计、研制提供生物力学基础。
3方法
3.1标本分组
30个猪胸12-骶1标本随机分为模拟腰4、5退变后路椎弓根螺钉固定椎间植骨组、植骨笼组、植钛网组，每组10个标本。
3.2各组标本应力遮挡效应应变电测量方法
首先对内固定前各组标本进行应变电测量，分别在各组标本椎弓根螺钉固定螺钉孔边缘部位粘贴电阻应变片，在电子万能试验机上模拟人的生理功能在压缩、前屈、后伸、左侧弯、右侧弯载荷作用下进行静态应变电测量，通过动静态电阻应变仪测量各测点的应变值，以单向虎克定律计算各测点的应力值。内固定前各组标本应变电测量完成后，待标本恢复24小时后，去除标本上的应变片；复制腰4、5退变后路椎弓根螺钉固定、椎间分别植骨、植骨笼、植钛网模型；之后在各组标本椎弓根螺钉螺钉孔边缘部位（与标本内固定前粘贴位置相同）粘贴电阻应变片，在电子万能试验机上模拟人的生理功能在压缩、前屈、后伸、左侧弯、右侧弯载荷作用下进行静态应变电测量，通过动静态电阻应变仪测量各测点的应变值，以单向虎克定律计算各测点的应力值。
3.3骨密度测量方法
骨密度测量标本为做完应变电测量实验后的标本。取各组标本固定部位边缘的腰椎松质骨在美国产Norlarid公司XR-600双能X射线骨密度仪上进行骨密度测量。
3.4骨组织学观察方法
取做完应变电测量实验后的各组标本，在固定部位边缘同一部位松质骨取样，进行固定，脱水、不脱钙，硬组织处理，以切片机沿椎体松质骨纵向切片，厚度为8μm，不染色，以德国蔡司公司生产的扫描电子显微镜进行组织学观察。
3.5骨组织形态计量参数测量方法
取做完应变电测量实验后的各组标本，在固定部位边缘同一部位松质骨试样，对试样进行固定、脱钙、包埋之后以切片机切片厚度为5μm，以图像分析系统测量骨小梁表面周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度。
4结果
4.1各组标本应变电测量结果表明：内固定后植骨组标本在压缩、前屈、后伸、左侧弯、右侧弯载荷作用下各测点的应变和应力均大于植骨笼组和植钛网组，差异显著（P<0.05）。内固定后植骨笼组标本在压缩、前屈、后伸、左侧弯、右侧弯载荷作用下各测点的应变和应力均大于植钛网组，差异显著（P<0.05）。
4.2各组骨密度测量结果表明：非固定部位松质骨骨密度大于植钛网组、植骨笼组、植骨组，差异显著（P<0.05）；植钛网组骨密度大于植骨笼组和植骨组，差异显著（P<0.05）；植骨笼组骨密度大于植骨组，差异显著（P<0.05）。
4.3各组松质骨骨组织学观察结果表明：非固定部位对照组松质骨骨小梁细密，纤维结构排列整齐；植钛网组1号测点边缘部位松质骨骨小梁变细、纤维结构排列有一定程度紊乱；植骨笼组1号测点边缘部位松质骨骨小梁多数变细、纤维结构排列紊乱；植骨组1号测点边缘部位松质骨骨小梁大多数变细，纤维结构排列更加紊乱、局部地方有空隙。
4.4骨组织形态计量参数测量结果表明：非固定部位对照组骨小梁表面周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度分别与植钛网组、植骨笼组、植骨组骨小梁表面周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度配对t检验，有统计学意义（P<0.05）。植钛网组骨小梁表面周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度分别与植骨笼组、植骨组骨小梁周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度配对t检验，有统计学意义（P<0.05）。植骨笼组骨小梁周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度与植骨组骨小梁周长、骨小梁面积、骨量、骨小梁厚度、骨小梁分离度配对t检验，有统计学意义（P<0.05）。
5结论
综合分析各组标本应变电测量结果、骨密度、骨组织形态观察结果、骨组织形态计量参数，可以得出以下结论：
5.1应变电测量结果表明：植钛网组植入物边缘5、6号测点和螺钉孔边缘部位1、2、3、4号测点在压缩、前屈、后伸、左侧弯、右侧弯受力状态下应变和应力小于植骨笼组和植骨组，有统计学意义，说明植钛网组应力遮挡效应最低。植骨笼组植入物边缘5、6号测点和螺钉孔边缘1、2、3、4号测点的应变和应力小于植骨组，有统计学意义，说明植骨笼组应力遮挡效应小于植骨组。椎间植钛网、植骨笼、植骨在外力作用下具有不同的应力遮挡效应。
5.2腰4、5植钛网融合组植入物边缘松质骨的骨密度大于植骨笼组和植骨组，有统计学意义，说明植钛网组在外力作用下，植入物边缘的松质骨的损伤小。
5.3植钛网组骨小梁周长、骨小梁面积、骨量、骨小梁厚度大于植骨笼组和植骨组，骨小梁分离度小于植骨笼组和植骨组，有统计学意义；说明植入不同的融合器对植入物边缘松质骨损伤程度不同，植钛网组损伤最小。
5.4植钛网组在外力作用下，螺钉孔边缘松质骨显微结构改变程度比植骨笼组、植骨组轻。
5.5植入物边缘松质骨的骨密度和应力遮挡效应基本呈负相关，即骨密度越大，应力遮挡效应越低。
5.6植入物边缘松质骨骨小梁周长、骨小梁面积、骨量、骨小梁厚度和植入物植入后应力遮挡效应基本呈正相关关系，骨小梁分离度和植入物植入后的应力集中和应力遮挡效应基本呈负相关关系。
5.7腰4、5退变后路椎弓根螺钉固定椎间植钛网融合在外力作用下，具有应力集中小和应力遮挡效应小的固定效果。
Research background
Lumbar degenerative diseases often require surgical treatment,which include posteriordecompression, pedicle screw fixation,disc removal and intervertebral bone graftfusion.Previous biomechanical researches and evaluation of spinal internal fixation deviceswere to simulate a spinal fracture and dislocation fixed with the fixation devices,then givethem the anteflexion, extension, left side bending,right side bending, compressive, torsiveloading or torque, to evaluate the stability by the displacement or the torsion Angle. There isno research of stress shield by simulation of posterior intervertebral fusion with threeintervertebral fusion devices in lumbar4、5degeneration with posterior pedicle screwfixation
Objective
To simulate posterior intervertebral fusion with three intervertebral fusion devices withposterior pedicle screw fixation of lumbar4、5degeneration,then measure stress shield,cancellous bone density of the fixed vertebral part, do the bone histomorphometry and bonemorphological observation on the basis of strain electrical measuring technology andprinciple, the rheological characteristics theory and with the help of electron microscopy andimage analysis technology and etc. Give an objective and system evaluation to the syncreticeffect of three kinds of intervertebral fusion devices;to provide biomechanical basis for thechoice of reasonable operation, the appropriate fixation devices of lumbar degenerationand new type of fixed equipment design and development.
Methods
3.1group the specimens
The thirty porcine spine specimens with T12to S1were randomly divided into threegroups, posterior intervertebral fusion with bone graft group (bone graft group), posteriorintervertebral fusion with bone cage group (bone cage group), posterior intervertebral fusion with titanium mesh group (titanium mesh group),in simulation of lumbar4、5degenerationwith posterior pedicle screw fixation,each group have10specimens.
3.2strain electrical measuring method of stress shield effect in each group
First measure the strain of each group before internal fixation. To simulate thebiological function of human,give the specimens compressive, anteflexion, extension, leftside bending, right side bending loading, do the strain electrical measurement of every pointof three groups after pastering of electric resistance strain gage by the help of the electronicaluniversal testing machine, calculate stress of every point by the one-way Hook’s Law. Thenmeasure the strain of each group after internal fixation.Remove the electric resistance straingage, give the specimens24hours to recover,simulate the model off posterior intervertebralfusion with three intervertebral fusion devices in lumbar4、5degeneration with posteriorpedicle screw fixation,do the same work as before.
3.3bone density measuring method
After strain electrical measurement of each specimen, measure the bone density byXR-600Dual-energy X-ray bone density instrument produced in America. The cancellousbone is carried from the same fringe of each fixed position of each group.
3.4method of histological observation of the bone
After strain electrical measurement of each specimen, carry cancellous bone from thesame fringe of each fixed position of each group,then fixed, dehydration, non-decalcification,do the section of8μm thickness，then do histological observation of the section by scanningelectron microscope produced by Zeiss company in Germany
3.5measuring method of the cancellous bone histomorphology
After strain electrical measurement of each specimen, carry cancellous bone from thesame fringe of each fixed position of each group,then fixed, decalcification,enbedding,do thesection of5μm thickness，measure the trabecular bone surface perimeter, trabecular bonesurface acreage, bone mass (trabecular bone), the trabecular bone thickness, degree ofseparation of the trabecular bone with the help of the image analysis systemResults
4.1The strain electrical measuring results show that the strain and the stress of the bonegraft group is bigger than the bone cage group and the titanium mesh group under thecompressive, anteflexion, extension, left side bending, right side bending loading at everymeasuring point, which has significant difference (P <0.05),the strain and the stress of thebone cage group is bigger than the titanium mesh group under the compressive, anteflexion, extension, left side bending, right side bending loading at every measuring point, whichhas significant difference (P <0.05).
4.2The measuring results of the bone density show that the bone density of the controllgroup is bigger than the titanium mesh group,the bone cage group and the bone graft group,which has significant difference (P <0.05), the bone density of the titanium mesh group isbigger than the bone cage group and the bone graft group, which has significant difference(P <0.05), the bone density of the bone cage group is bigger than the bone graft group,which has significant difference (P <0.05).
4.3The histological observation of the cancellous bone show that the trabecula of thecontroll group is fine and dense,the structure is in alignment, some of the trabecula of thetitanium mesh group is thinner and the structure have a certain degree disorder, most of thetrabecula of the bone cage group is thinner and the structure is in a mess, almost all of thetrabecula of the bone graft group is thinner and the structure is in a chaos,there is gap in it.
4.4The measuring results of the cancellous bone histomorphology show that thetrabecular bone surface perimeter, trabecular bone surface acreage, bone mass (trabecularbone), the trabecular bone thickness, degree of separation of the trabecular bone of thecontroll group pairs respectively with the titanium group, the bone cage group,the bone graftgroup, the matching t-test has statistical significance (P <0.05). The measuring results of thecancellous bone histomorphology show that the trabecular bone surface perimeter, trabecularbone surface acreage, bone mass (trabecular bone), the trabecular bone thickness, degree ofseparation of the trabecular bone of the titanium mesh group pairs respectively with the bonecage group,the bone graft group, the matching t-test has statistical significance (P <0.05).The measuring results of the cancellous bone histomorphology show that the trabecular bonesurface perimeter, trabecular bone surface acreage, bone mass (trabecular bone), thetrabecular bone thickness, degree of separation of the trabecular bone of the bone cage grouppairs with the bone graft group, the matching t-test has statistical significance (P <0.05).Conclusions
5.1The strain electrical measuring results show that the strain and the stress of thetitanium mesh group is smaller than the bone cage group and the titanium mesh group underthe compressive, anteflexion, extension, left side bending, right side bending loading atevery measuring point, which has significant difference (P <0.05), which illustrate that thestress shield of the titanium mesh group is the lowest. The strain and the stress of the bonecage group is smaller than the bone graft group under the compressive, anteflexion, extension, left side bending, right side bending loading at every measuring point, whichhas significant difference (P <0.05), which illustrate that the stress shield of the bone cagegroup is lower than the bone graft group. The titanium mesh group,the bone cage group andthe bone graft group has different stress shield.
5.2The measuring results of the bone density show that the bone density of the titaniummesh group is bigger than the bone cage group and the bone graft group, which hasstatistical difference (P <0.05), which illustrate the cancellous bone’s injury of the titaniumis smallest under the loading.
5.3The measuring results of the cancellous bone histomorphology show that thetrabecular bone surface perimeter, trabecular bone surface acreage, bone mass (trabecularbone), the trabecular bone thickness, degree of separation of the trabecular bone of thecontroll group pairs respectively with the titanium group, the bone cage group,the bone graftgroup, the matching t-test has statistical significance (P <0.05), which illustrate thecancellous bone’s injury of the titanium is smallest under different loading.
5.4The histological observation of the cancellous bone show that the change of thetrabecula structure in the titanium mesh group is gentle.
5.5The measuring results of the bone density show that the bone density was inverselyassociated with the stress shield effect, the greater of the bone density, the lower of the stressshield effect
5.6The measuring results of the cancellous bone histomorphology show that thetrabecular bone surface perimeter, trabecular bone surface acreage, bone mass (trabecularbone), the trabecular bone thickness and stress shield are positive correlation, degree ofseparation of the trabecular bone and stress shield are negative correlation.
5.7Posterior intervertebral fusion with titanium mesh in lumbar4、5degeneration withposterior pedicle screw fixation has a small stress concentration and stress shield effect.
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