Hitchon P W, Goel V K, Rogge T, Grosland N M, Torner J
Division of Neurosurgery, University of Iowa, Iowa City, USA.
Spine (Phila Pa 1976). 1999 Feb 1;24(3):213-8. doi: 10.1097/00007632-199902010-00004.
A biomechanical comparison of two commonly used anterior spinal devices: the Smooth Rod Kaneda and the Synthes Anterior Thoracolumbar Spinal Plate.
To compare the stability imparted to the human cadaveric spine by the Smooth Rod Kaneda and Synthes Anterior Spinal Plate, and to assess how well these devices withstand fatigue and uni- and bilateral facetectomy.
Biomechanical studies on the aforementioned and similar devices have been performed using synthetic, porcine, calf, or dog spines. As of the time of this writing, studies comparing anterior spinal implants using human cadaveric spines are scarce.
An L1 corpectomy was performed on 19 spines. Stabilization was accomplished by an interbody wooden graft and the application of the Smooth Rod Kaneda in 10 spines and the Synthes Anterior Spinal Plate in the remaining 9. Biomechanical testing of the spines was performed in six degrees of freedom before and after stabilization, and after fatiguing to 5000 cycles of +/- 3 Nm of flexion and extension. Testing was repeated after uni- and bilateral facetectomy.
After stabilization, the Smooth Rod Kaneda was significantly more rigid than the anterior thoracolumbar bar spinal plate in extension. After fatigue, the Smooth Rod Kaneda was significantly stiffer than the anterior thoracolumbar spinal plate in flexion, extension, right lateral bending, left lateral bending, and right axial rotation. A significant decrease in stiffness was noted with the Synthes device in flexion after bilateral facetectomy compared with the stabilized spine.
The smooth Rod Kaneda device tends to be stiffer than the anterior thoracolumbar spinal plate, particularly in extension, exceeding the anterior thoracolumbar spinal plate in fatigue tolerance. The spine stabilized with the anterior thoracolumbar spinal plate is more susceptible to the destabilizing effect of bilateral facetectomy than than that stabilized with the Smooth Rod Kaneda. The additional rigidity encountered with the Smooth Rod Kaneda must be weighed against the simplicity of anterior thoracolumbar spinal plate application.
两种常用前路脊柱器械的生物力学比较：平滑杆式Kaneda器械和Synthes前路胸腰椎脊柱钢板。
比较平滑杆式Kaneda器械和Synthes前路脊柱钢板赋予人体尸体脊柱的稳定性，并评估这些器械在承受疲劳以及单侧和双侧小关节切除时的性能。
已使用合成脊柱、猪脊柱、小牛脊柱或狗脊柱对上述及类似器械进行了生物力学研究。在撰写本文时，使用人体尸体脊柱比较前路脊柱植入物的研究很少。
对19个脊柱进行L1椎体次全切除。通过椎间植骨以及在10个脊柱中应用平滑杆式Kaneda器械和在其余9个脊柱中应用Synthes前路脊柱钢板来实现稳定。在稳定前后以及在经受±3 Nm屈伸5000次循环疲劳后，对脊柱进行六个自由度的生物力学测试。在单侧和双侧小关节切除后重复测试。
稳定后，平滑杆式Kaneda器械在伸展时比前路胸腰椎钢板明显更具刚性。疲劳后，平滑杆式Kaneda器械在屈伸、右侧侧弯、左侧侧弯和右侧轴向旋转方面比前路胸腰椎脊柱钢板明显更硬。与稳定的脊柱相比，双侧小关节切除后Synthes器械在屈曲时刚度显著降低。
平滑杆式Kaneda器械往往比前路胸腰椎脊柱钢板更硬，尤其是在伸展时，在疲劳耐受性方面超过前路胸腰椎脊柱钢板。与用平滑杆式Kaneda器械稳定的脊柱相比，用前路胸腰椎脊柱钢板稳定的脊柱更容易受到双侧小关节切除的去稳定作用影响。必须在平滑杆式Kaneda器械额外的刚性与前路胸腰椎脊柱钢板应用的简便性之间进行权衡。
