全脊椎切除术后三种不同重建方法的稳定性比较

目的：评价全脊椎切除术后应用三种不同重建方式对脊柱稳定性的影响。方法：选用6具新鲜尸体T9～L3脊柱标本，建立T12全脊椎切除模型．进行三种不同的前后方重建：（1）前方人工椎体＋后方椎弓根螺钉固定；（2）前方人工椎体、钢板＋后方椎弓根螺钉固定；（3）前方骨水泥-螺钉复合体＋后方椎弓根螺钉固定。采用非损伤性加载对完整标本和三种重建方式下的每个脊柱标本的稳定性进行测试。结果：三种方法重建术后在4N载荷下T11～Ll各运动方向的平均运动范围均较完整标本小（P〈0．001），三种重建方式之间无统计学差异（P〉0．05）。结论：全脊椎切除术后三种重建方式均可以重建脊柱的稳定性。

Comparative study of three kinds of reconstructed spinal stability after total spondylectomy

Objective:To evaluate the effect of three kinds of reconstructed spinal stability after total spondylectomy.Method:Six fresh-frozen human cadaveric spines(T9-L3) were used.A total spondylectomy was performed at T12.Three potential reconstruction techniques were tested for their ability to restore stiffness of the specimen:(1)anterior artificial centrum and multilevel posterior pedicle screw instrumentation;(2)anterior artificial centrum and plate with multilevel posterior pedicle screw instrumentation;(3)anterior bone cement-screw complex with multilevel posterior pedicle screw instrumentation.Each of the six intact specimens and the three potential reconstruction techniques was tested using nondestructive testing under load control.Result:All reconstructed groups provided more stability to the specimen than intact spine in all loading modes(P<0.001).No statistical difference was found among three reconstruction groups(P>0.05).Conclusion:Three kinds of reconstruction techniques can equally provide stability after total spondylectomy.