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聚醚醚酮棒系统与传统钛棒固定的生物力学评估与比较

Biomechanical evaluation and comparison of polyetheretherketone rod system to traditional titanium rod fixation.

作者信息

Ponnappan Ravi K, Serhan Hassan, Zarda Brett, Patel Ravi, Albert Todd, Vaccaro Alexander R

机构信息

Department of Orthopaedic Surgery, Jefferson Medical College, 925 Chestnut Street, Philadelphia, PA 19107, USA.

出版信息

Spine J. 2009 Mar;9(3):263-7. doi: 10.1016/j.spinee.2008.08.002. Epub 2008 Oct 1.

Abstract

BACKGROUND CONTEXT

Polyetheretherketone (PEEK) has been increasingly used as a biomaterial for spinal implants. PEEK lumbar fusion rods have recently become available for use in posterior lumbar fusion procedures.

PURPOSE

To compare Polyetheretherketone Rod System to traditional titanium rod fixation in a cadaveric model and provide mechanical test data for the PEEK system.

STUDY DESIGN

Biomechanical testing.

METHODS

Cadaveric biomechanical testing was conducted to compare Expedium 5.5 mm PEEK rods to titanium rods of equivalent diameter. Biomaterials testing was performed to determine static and dynamic performance of Expedium 5.5 mm PEEK rods with 6% BaSo4 in compressive bending and torsion.

RESULTS

Cadaveric testing demonstrated that PEEK rods can significantly reduce the range of motion of a destabilized segment. The testing showed no significant difference in the stability provided by PEEK and titanium rods in posterolateral fusion (PLF) or posterior lumbar interbody fusion (PLIF) constructs. PEEK static compressive bending tests showed 67 degrees displacement without fracture of the rod. Torsion testing showed 30 degrees of rotation without yield or plastic deformation. Dynamic compression testing revealed two fatigue runouts at 23 degrees.

CONCLUSIONS

PEEK rods provide comparable stability to titanium rods of equivalent diameter in cadaveric testing. Mechanical testing suggests PEEK rods can withstand far beyond the angular displacements suggested by cadaveric testing and that of normal physiologic range of motion. Potential advantages to PEEK rods include better anterior column load sharing, reduced stress at bone-to-screw interface, and reduced computed tomography and magnetic resonance imaging scatter and artifact.

摘要

背景

聚醚醚酮(PEEK)已越来越多地用作脊柱植入物的生物材料。PEEK腰椎融合棒最近已可用于后路腰椎融合手术。

目的

在尸体模型中将聚醚醚酮棒系统与传统钛棒固定进行比较,并为PEEK系统提供力学测试数据。

研究设计

生物力学测试。

方法

进行尸体生物力学测试,以比较5.5毫米Expedium PEEK棒与同等直径的钛棒。进行生物材料测试,以确定含6%硫酸钡的5.5毫米Expedium PEEK棒在压缩弯曲和扭转中的静态和动态性能。

结果

尸体测试表明,PEEK棒可显著减少不稳定节段的活动范围。测试显示,在外侧后融合(PLF)或后路腰椎椎间融合(PLIF)结构中,PEEK棒和钛棒提供的稳定性无显著差异。PEEK静态压缩弯曲测试显示,棒在位移67度时未断裂。扭转测试显示,旋转30度时未出现屈服或塑性变形。动态压缩测试显示,在23度时有两次疲劳至极限。

结论

在尸体测试中,PEEK棒与同等直径的钛棒具有相当的稳定性。力学测试表明,PEEK棒能够承受远超尸体测试和正常生理活动范围所表明的角位移。PEEK棒的潜在优势包括更好的前柱负荷分担、骨与螺钉界面处应力降低以及计算机断层扫描和磁共振成像散射及伪影减少。

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