与人类颈椎节段相比,猪颈椎在评估脊柱植入物方面的局限性:采用不同器械技术对猪和人类颈椎标本进行的体外生物力学比较
Limitations of the cervical porcine spine in evaluating spinal implants in comparison with human cervical spinal segments: a biomechanical in vitro comparison of porcine and human cervical spine specimens with different instrumentation techniques.
作者信息
Schmidt René, Richter Marcus, Claes Lutz, Puhl Wolfhart, Wilke Hans-Joachim
机构信息
Department of Orthopedics and SCI, University of Ulm, Ulm, Germany.
出版信息
Spine (Phila Pa 1976). 2005 Jun 1;30(11):1275-82. doi: 10.1097/01.brs.0000164096.71261.c2.
STUDY DESIGN
Porcine and human cervical spine specimens were in vitro biomechanically compared with different instrumentation techniques.
OBJECTIVES
To evaluate whether subaxial porcine cervical spines are a valid model for implant testing in a single level corpectomy.
SUMMARY OF BACKGROUND DATA
Biomechanical in vitro tests are widely used for implant tests, mainly with human spine specimens. The availability of human cadavers is limited and the properties of the specimen regarding age, bone mineral density, and grade of degenerative changes is inhomogeneous.
METHODS
Six porcine and six human cervical specimens were loaded nondestructively with pure moments: 1) in an intact state; 2) after a corpectomy of C5 and substitution by a cage with integrated force sensor; 3) after additional instrumentation with a posterior screw and rod system with: a) lateral mass and b) pedicle screws; 4) after instrumentation with an anterior plate; and 5) with a circumferential instrumentation. The unconstrained motion and the axial loads occurring in the corpectomy gap were measured, as well as the bone mineral density of the specimen before testing.
RESULTS
The range of motion in the intact state, as well as for the different instrumentations, was comparable for flexion-extension. In lateral bending and axial rotation, marked differences in the intact state as well as for pedicle screw instrumentations occurred.
CONCLUSIONS
The subaxial porcine cervical spine is a potential model in flexion-extension because of its biomechanical similarity. For lateral bending and axial rotation, the marked differences severly restrict the comparability.
研究设计
对猪和人类颈椎标本采用不同的内固定技术进行体外生物力学比较。
目的
评估猪颈椎下颈椎是否是单节段椎体次全切除术中植入物测试的有效模型。
背景数据总结
体外生物力学测试广泛用于植入物测试,主要使用人类脊柱标本。人体尸体的可用性有限,且标本在年龄、骨密度和退变程度方面的特性不均匀。
方法
对六个猪颈椎标本和六个人类颈椎标本施加无损纯力矩:1)完整状态;2)C5椎体次全切除并用带集成力传感器的椎间融合器替代后;3)额外采用后路螺钉和棒系统固定后,分别使用:a)侧块螺钉和b)椎弓根螺钉;4)前路钢板固定后;5)环形固定后。测量椎体次全切除间隙中出现的无约束运动和轴向载荷,以及测试前标本的骨密度。
结果
完整状态下以及不同固定方式下的屈伸运动范围具有可比性。在侧弯和轴向旋转时,完整状态以及椎弓根螺钉固定方式下存在显著差异。
结论
由于生物力学相似性,猪颈椎下颈椎在屈伸方面是一个潜在模型。对于侧弯和轴向旋转,显著差异严重限制了可比性。