The Study Of Lumbar Interbody Fusion In The Treatment Of Lumbar Degenerative Disease

Abstract:bjective:To adopt single interbody fusion n-HA/PA66 biomechanical testing of different implantation mode,and CAGE implantation and single kidney type comparison;2.on the basis of animal experiment,through the comparison of clinical lumbar surgery in our hospital patients and follow-up results of analysis,put forward a new single CAGE implantation;Methods:20 healthy male white section to the fifth section of the second spine specimens,adjacent to lumbar 2/3 and lumbar vertebral body was two 4/5 experimental segments,36 segments of the experiment,were randomly divided into four groups(each group of 8 experimental segmental specimens):control group A group:posterior pedicle screw fixation;B group:posterior pedicle screw and single Cage oblique intervertebral bone graft;C group:posterior pedicle screw and single Cage lateral intervertebral bone grafting;D group:posterior pedicle screws + intervertebral bone graft kidney Cage.A group of posterior pedicle screw fixation(reference group);B,C,D group(experimental group),B,C,D groups were to be left by transforaminal TLIF(transforaminal lumbar interbody fusion,TLIF)and bone graft,and give different direction Cage implanted pedicle screw fixation.Before the experiment on X-ray measured from the original model of intervertebral height,vertebral Cage distance relative displacement of the vertebral width were measured after the experiment on ballast specimens existing intervertebral height and Cage distance from the posterior margin of the vertebral body relative displacement in x-ray.By the biomechanical machine of ballast,B,C and D were tested in flexion,extension,left lateral flexion,rotation,flexion,left right right intervertebral height change rotation,compression in 7 directions(with Kirschner wire in the movement range of range of motion,ROM,contrast)rotation angle around the relation with stress and the displacement of Cage(with Cage distance posteriormarginal distance comparison),the analysis of load test data comparison B,C,D were pressed in biomechanical differences.Then collected in our hospital in recent 2 years,150 cases of clinical findings,imaging of patients with degenerative lumbar spine before surgery in patients with symptoms and imaging findings and postoperative clinical symptom score follow-up data,the oblique implanted in 75 patients as group Al,75 cases of transverse implantation were selected as B1 group,through the follow-up of patients January,March,June after discharge,December,24 month outpatient review X and CT,were measured after January,March,June,December,the 24 month Cage shift,intervertebral height changes,postoperative intervertebral fusion area,March June December,interbody fusion area and intervertebral fusion area,24 month interbody fusion area.Comparison of preoperative and postoperative loss of intervertebral height and physiological curvature of the spine is lost,intervertebral fusion rate,lumbar back pain recurrence rate and the incidence rate of pedicle that.Results:there was no significant difference in the height of intervertebral space between the experimental groups and the first four groups(P>0.05);The B,C,D three groups of intervertebral height and before the experiment has increased,but no significant difference was not statistically significant(P>0.05),no statistically significant B,C,D group of postoperative intervertebral height difference(P>0.05).B group of postoperative left lateral flexion,extension,vertical direction of 3 intervertebral height changes,Cage shift and C,there were no significant differences between D,the difference was not statistically significant(P>0.05),B group in flexion,flexion,rotation,right turn left 4 directions of the height change of intervertebral space and Cage displacement is greater C,D group,the difference was statistically significant(P<0.05);the height change of intervertebral space and Cage displacement of C and D groups showed no significant difference(P>0.05),24 months after operation in group A1 intervertebral height changes,the back pain recurrence rate and lumbar lordosis lost more than group B1,bone fusion the rate of less than B1 group,the differences were statistically significant(P<0.05).Conclusion:the animal model of the biomechanical test results show that the transverse stress in the implanted Cage test,compared with the oblique implantation can maintain the intervertebral height;lateral oblique position was implanted into Cage more centered,make spinal stress more points Scattered,reduced intervertebral space narrowing,Cage displacement and pedicle screws fracture incidence nail,can maintain the stability of the spine;intervertebral bone grafting Cage into lateral spread more widely,and the oblique bone fusion rate higher than Cage;Cage operation with implant lateral oblique implantation has the advantage,when feasible.