寰枢椎前路可动固定系统的犬活体动物实验研究
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摘要
目的利用犬活体动物模型探讨寰枢椎前路可动固定系统假体长期放置后的力学稳定性及组织相容性,为进一步临床应用提供理论依据。方法 18只正常成年雄性杂交犬随机分为正常对照组、寰枢椎前路可动固定组和Harms固定融合组,分别施行假手术、可动固定术及Harms钢板固定融合术。各组实验犬饲养12周后处死,取可动固定组及正常对照组假体邻近软组织、引流淋巴结、脾脏、肝脏组织行HE染色,取可动固定组颈椎标本行硬组织切片染色,观察假体组织相容性;取新鲜颈椎标本(C_0～C_2)制备生物力学测试模型,在MTS 858生物材料试验机上测定各组颈椎标本的三维运动范围与中性区。结果 HE染色结果显示可动固定组假体周围组织、引流淋巴结、脾脏、肝脏均正常,无含铁血黄素沉积,无炎症反应,未见金属颗粒。硬组织切片染色可见可动固定假体周围无炎症反应,假体骨组织界面无松动。生物力学测试结果显示,前路可动固定术后,寰枢椎在屈伸、侧屈及旋转运动下的运动范围和中性区与完整状态相似,差异无统计学意义(P>0.05)。结论寰枢椎前路可动固定系统具有良好的组织相容性,低磨损,能够在活体内长期稳定放置的基础上保留寰枢椎的运动功能。
Objective To investigate the mechanical stability and histocompatibility of the anterior motion-preserving atlantoaxial fixation device after long-term implantation in a canine model, which provided a theoretical basis for further clinical application. Methods Eighteen adult male canines were randomly divided into normal control group, motion-preserving atlantoaxial fixation group and Harms fixed fusion group. Sham operation, movable fixation and Harms plate fixation were performed respectively. After 12 weeks of feeding, the experimental canines in normal control group and motion-preserving atlantoaxial fixation group were sacrificed and treated with HE staining for adjacent soft tissues, draining lymph nodes, spleen and liver tissues. Sections of the cervical spine in motion-preserving atlantoaxial fixation group were stained to observe the histocompatibility of the prosthesis. Fresh cervical spine specimens(C_0-C_2) were prepared for biomechanical test models. And the three-dimensional range of motion and neutral zone of each group of cervical spine specimens were determined on biomaterial testing machine. Results HE staining showed that the tissue around the prosthesis, draining lymph nodes, spleen and liver were normal. No hemosiderin deposition, inflammatory reaction, and metal particles were observed. Biomechanical test showed that, after the motion-preserving atlantoaxial fixation, the range of motion and neutral zone of atlantoaxial specimens in flexion, extension, lateral bending, and rotation were similar to those of the intact state. Conclusion The anterior motion-preserving atlantoaxial fixation system has good histocompatibility, low wear, and can maintain the long-term stable implantation in vivo while retaining the motion function of the atlantoaxial joint.
Objective To investigate the mechanical stability and histocompatibility of the anterior motion-preserving atlantoaxial fixation device after long-term implantation in a canine model, which provided a theoretical basis for further clinical application. Methods Eighteen adult male canines were randomly divided into normal control group, motion-preserving atlantoaxial fixation group and Harms fixed fusion group. Sham operation, movable fixation and Harms plate fixation were performed respectively. After 12 weeks of feeding, the experimental canines in normal control group and motion-preserving atlantoaxial fixation group were sacrificed and treated with HE staining for adjacent soft tissues, draining lymph nodes, spleen and liver tissues. Sections of the cervical spine in motion-preserving atlantoaxial fixation group were stained to observe the histocompatibility of the prosthesis. Fresh cervical spine specimens(C_0-C_2) were prepared for biomechanical test models. And the three-dimensional range of motion and neutral zone of each group of cervical spine specimens were determined on biomaterial testing machine. Results HE staining showed that the tissue around the prosthesis, draining lymph nodes, spleen and liver were normal. No hemosiderin deposition, inflammatory reaction, and metal particles were observed. Biomechanical test showed that, after the motion-preserving atlantoaxial fixation, the range of motion and neutral zone of atlantoaxial specimens in flexion, extension, lateral bending, and rotation were similar to those of the intact state. Conclusion The anterior motion-preserving atlantoaxial fixation system has good histocompatibility, low wear, and can maintain the long-term stable implantation in vivo while retaining the motion function of the atlantoaxial joint.
引文
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[13]Johnson JA,da Costa RC,Bhattacharya S,et al.Kinematic motion patterns of the cranial and caudal canine cervical spine[J].Vet Surg,2011,40(6):720-727.
[14]Shriver MF,Kshettry VR,Sindwani R,et al.Transoral and transnasal odontoidectomy complications:a systematic review and metaanalysis[J].Clin Neurol Neurosurg,2016,148:121-129.
[15]Kim SM,Lim TJ,Paterno J,et al.Biomechanical comparison of anterior and posterior stabilization methods in atlantoaxial instability[J].J Neurosurg,2004,100(3 Suppl Spine):277-283.
[2]Nakagawa H,Yagi K.Advancement in atlantoaxial fixation[J].World Neurosurg,2014,82(1-2):e143-e144.
[3]Du JY,Aichmair A,Kueper J,et al.Biomechanical analysis of screw constructs for atlantoaxial fixation in cadavers:a systematic review and meta-analysis[J].J Neurosurg Spine,2015,22(2):151-161.
[4]Rajinda P,Towiwat S,Chirappapha P.Comparison of outcomes after atlantoaxial fusion with C1 lateral mass-C2 pedicle screws and C1-C2 transarticular screws[J].Eur Spine J,2017,26(4):1064-1072.
[5]Derman PB,Lampe LP,Lyman S,et al.Atlantoaxial fusion:sixteen years of epidemiology,indications,and complications in New York state[J].Spine(Phila Pa 1976),2016,41(20):1586-1592.
[6]Skeppholm M,Lindgren L,Henriques T,et al.The Discover artificial disc replacement versus fusion in cervical radiculopathy-a randomized controlled outcome trial with 2-year follow-up[J].Spine J,2015,15(6):1284-1294.
[7]Goel A.Artificial atlantoaxial joint:Is it a possible option?[J].JCraniovertebr Junction Spine,2015,6(4):147-148.
[8]胡勇,杨述华,谢辉,等.经口咽入路人工寰齿关节置换术的解剖学研究[J].中华骨科杂志,2006,26(11):739-743.
[9]Cai X,He X,Li H,et al.Total atlanto-odontoid joint arthroplasty system:a novel motion preservation device for atlantoaxial instability after odontoidectomy[J].Spine(Phila Pa 1976),2013,38(8):E451-E457.
[10]蔡璇,李浩鹏,董军,等.人工寰齿关节置换活体动物模型的建立及相关研究[J].生物骨科材料与临床研究,2018,15(2):5-8.
[11]Jandhyala BS,Hom GJ.Minireview:physiological and pharmacological properties of vanadium[J].Life Sci,1983,33(14):1325-1340.
[12]Hao YL,Li SJ,Sun BB,et al.Ductile titanium alloy with low poisson's ratio[J].Phys Rev Lett,2007,98(21):216405.
[13]Johnson JA,da Costa RC,Bhattacharya S,et al.Kinematic motion patterns of the cranial and caudal canine cervical spine[J].Vet Surg,2011,40(6):720-727.
[14]Shriver MF,Kshettry VR,Sindwani R,et al.Transoral and transnasal odontoidectomy complications:a systematic review and metaanalysis[J].Clin Neurol Neurosurg,2016,148:121-129.
[15]Kim SM,Lim TJ,Paterno J,et al.Biomechanical comparison of anterior and posterior stabilization methods in atlantoaxial instability[J].J Neurosurg,2004,100(3 Suppl Spine):277-283.