Rohlmann A, Bergmann G, Graichen F, Weber U
Oskar-Helene-Heim, Orthopädische Klinik und Poliklinik, Freie Universität Berlin.
Orthopade. 1999 May;28(5):451-7.
The loads acting on internal spinal fixation devices were measured for different activities in ten patients using telemeterized bisegmental implants. The highest loads were found for walking and lateral bending of the upper body while standing. When bending forwards the upper body, the fixator loads were only slightly altered. The forces and moments were not higher during sitting than during standing. Therefore, sitting should be allowed for patients with instrumented spines as soon as getting up is allowed. The forces and moments in the fixators were often altered due to anterior interbody fusion. Especially in patients with degenerative instability, the implant loads were higher after anterior interbody fusion than before. Braces were not able to markedly reduce the fixator loads. Therefore, it does not seem helpful to brace patients after mono- or bisegmental stabilization of the thoracic or lumbar spine.
使用遥测双节段植入物对10名患者在不同活动时作用于脊柱内固定装置的负荷进行了测量。发现站立时行走和上身侧弯的负荷最高。上身向前弯曲时,固定器负荷仅有轻微变化。坐着时的力和力矩并不比站立时高。因此,只要允许起床,有脊柱内固定装置的患者就应被允许坐着。由于前路椎间融合,固定器中的力和力矩常常发生变化。特别是在退行性不稳定患者中,前路椎间融合后的植入物负荷高于融合前。支具不能显著降低固定器负荷。因此,在胸腰椎单节段或双节段稳定后对患者使用支具似乎并无帮助。