背景:非融合技术,如运动保存装置,已经开始了脊柱外科治疗选择的新时代。保留运动的方法主要包括进行颈前路椎间盘切除和融合的全椎间盘置换。然而,对于多段融合,如颈椎前路椎体全切术和融合术,选项更加有限。因此,我们设计了一种用于多节段融合的新型3D打印运动保留人工颈椎全切术构建体(ACCC)。本研究的目的是探索ACCC在山羊模型中的可行性。
方法:山羊接受前C3全切术和ACCC植入治疗,并随机分为两组,分别在3或6个月进行评估。射线照相术,进行3DCT重建和MRI评估。使用显微CT和组织学评估生物相容性。
结果:术后,所有山羊都处于良好状态,颈部自由运动。植入物定位是最佳的。关节突关节间关系稳定。术后3个月和6个月屈伸期间C2-C4节段的运动范围分别为7.8°和7.3°,分别。植入物被新的骨组织包裹着,已经长成多孔结构。软骨组织,骨化中心,新血管,在多孔金属椎骨-骨界面和金属孔中观察到骨矿化。
结论:ACCC提供了稳定性,同时保持了功能性脊柱单元的运动并促进了骨再生和血管形成。在这项研究中,在山羊模型中,ACCC用于颈椎前路椎体切除和融合术(ACCF).我们希望这项研究将推动运动保持装置的进一步研究。
BACKGROUND: Nonfusion technologies, such as motion-preservation devices, have begun a new era of treatment options in spine surgery. Motion-preservation approaches mainly include total disc replacement for anterior cervical discectomy and fusion. However, for multisegment fusion, such as anterior cervical corpectomy and fusion, the options are more limited. Therefore, we designed a novel 3D-printed motion-preservation artificial cervical corpectomy construct (ACCC) for multisegment fusion. The aim of this study was to explore the feasibility of ACCC in a goat model.
METHODS: Goats were treated with anterior C3 corpectomy and ACCC implantation and randomly divided into two groups evaluated at 3 or 6 months. Radiography, 3D CT reconstruction and MRI evaluations were performed. Biocompatibility was evaluated using micro-CT and histology.
RESULTS: Postoperatively, all goats were in good condition, with free neck movement. Implant positioning was optimal. The relationship between facet joints was stable. The range of motion of the C2-C4 segments during flexion-extension at 3 and 6 months postoperatively was 7.8° and 7.3°, respectively. The implants were wrapped by new bone tissue, which had grown into the porous structure. Cartilage tissue, ossification centres, new blood vessels, and bone mineralization were observed at the porous metal vertebrae-bone interface and in the metal pores.
CONCLUSIONS: The ACCC provided stabilization while preserving the motion of the functional spinal unit and promoting bone regeneration and vascularization. In this study, the ACCC was used for anterior cervical corpectomy and fusion (ACCF) in a goat model. We hope that this study will propel further research of motion-preservation devices.