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[不同椎体假体在椎体切除术后椎体间融合术中迁移及初始稳定性的比较,椎体切除术伴或不伴椎板切除术]

[Comparison of different vertebral body prosthesis with reference to migration and primary stability in dorsoventral spondylodesis after corporectomy with and without laminectomy].

作者信息

Morlock M, Strandborg J, Sellenschloh K, Nassutt R, Püschel K, Eggers C

机构信息

Technische Universität Hamburg-Harburg, Denickestrasse 15, 21073 Hamburg.

出版信息

Orthopade. 2002 May;31(5):514-21. doi: 10.1007/s00132-001-0294-5.

Abstract

In order to allow speedy mobilization after vertebral body replacement, high primary stability as well as prevention of implant dislocation are required. It is unclear whether differences between common vertebral body replacement systems exist and whether spreadable implants improve primary stability. Migration characteristics of 3 different vertebral body replacement systems were determined using human lumbar spine specimens. Primary stability was assessed by loading specimens successively in 5 conditions: native, after dorsal spondylodesis, after laminectomy and after vertebral body replacement. Migration was shown to depend on cage design and spike shape. Dorsal spondylodesis in combination with vertebral body replacement reduced flexion/extension movement effectively independent of cage design. Stabilization potential in lateral bending was limited. None of the cages limited movement under torsional loading effectively. The possibility to spread the cage had a positive effect on stabilization.

摘要

为了在椎体置换后实现快速活动,需要高初始稳定性以及防止植入物脱位。目前尚不清楚常见椎体置换系统之间是否存在差异,以及可扩张植入物是否能提高初始稳定性。使用人体腰椎标本确定了3种不同椎体置换系统的移位特征。通过在5种条件下连续加载标本评估初始稳定性:天然状态、后路脊柱融合术后、椎板切除术后以及椎体置换术后。结果表明,移位取决于椎间融合器设计和钉的形状。后路脊柱融合术联合椎体置换可有效减少屈伸运动,与椎间融合器设计无关。侧弯时的稳定潜力有限。没有一种椎间融合器能有效限制扭转负荷下脊柱的运动。椎间融合器的可扩张性对稳定性有积极影响。

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