Wilke H J, Kavanagh S, Neller S, Claes L
Institut für Unfallchirurgische Forschung und Biomechanik, Universität Ulm, Helmholtzstrasse 14, 89081 Ulm.
Orthopade. 2002 May;31(5):434-40. doi: 10.1007/s00132-001-0286-5.
This study investigated whether after a nucleotomy and implantation of a prosthetic disk nucleus (PDN) the original height and mobility of an L4/L5 disk can be restored. Compared to the intact state (100%), nucleotomy increased the median values of the normalized range of motion (ROM) in flexion/extension to 118%, lateral bending to 112%, and axial rotation to 121%. PDN implantation reduced ROM to 102%, 88%, and 90%. These differences were even more distinct when comparing the neutral zone (NZ) with 210%, 173%, and 107% after nucleotomy and 146%, 149%, and 44% after PDN implantation. With an axial preload of 200 N, disk height after nucleotomy was reduced by about 1.3 mm and could be restored with PDN implantation. PDN implantation can restore disk height and ROM after nucleotomy to normal values and reduce the strong NZ increase. Further biomechanical characterization of this therapy with PDN is necessary.
本研究调查了髓核摘除术及人工椎间盘髓核（PDN）植入后，L4/L5椎间盘的原始高度和活动度是否能够恢复。与完整状态（100%）相比，髓核摘除术后，屈伸活动度（ROM）的标准化范围中位数增加至118%，侧弯增加至112%，轴向旋转增加至121%。PDN植入后，ROM分别降至102%、88%和90%。与中性区（NZ）相比，这些差异更为明显，髓核摘除术后中性区分别为210%、173%和107%，PDN植入后分别为146%、149%和44%。在200 N的轴向预载下，髓核摘除术后椎间盘高度降低约1.3 mm，PDN植入后可恢复。PDN植入可使髓核摘除术后的椎间盘高度和ROM恢复至正常值，并减少中性区的显著增加。有必要对这种PDN治疗方法进行进一步的生物力学特性研究。
