后路颈椎术前术后板间模型中使用横向连接器的生物力学效应：一项尸体体外研究。
The biomechanical effect of transverse connectors use in a pre- and postlaminectomy model of the posterior cervical spine: an in vitro cadaveric study.
机构信息
Orthopedic & Spine Specialists, York, PA 17402, USA.
出版信息
Spine (Phila Pa 1976). 2011 Dec 15;36(26):E1694-701. doi: 10.1097/BRS.0b013e3182276735.
STUDY DESIGN
An in vitro biomechanical study investigating the effect of transverse connectors on posterior cervical stabilization system in a laminectomy model.
OBJECTIVE
To evaluate the optimal design, number, and location of the transverse connectors in stabilizing long segment posterior instrumentation in the cervical spine.
SUMMARY OF BACKGROUND DATA
In the cervical spine, lateral mass screw (LMS) fixation is used for providing stability after decompression. Transverse connectors have been used to augment segmental posterior instrumentation. However, in the cervical region the optimal design, number, and the location of transverse connectors is not known.
METHODS
Seven fresh human cervicothoracic cadaveric spines (C2-T1) were tested by applying ±1.5 Nm moments in flexion (F), extension (E), lateral bending (LB), and axial rotation (AR). After testing the intact condition, LMS/rods were placed and then were tested with two different transverse connectors (top-loading connector [TL] and the head-to-head [HH] connector) in multiple levels, pre- and postlaminectomy (PL).
RESULTS
LMS significantly reduced segmental motion by 77.2% in F, 75.6% in E, 86.6% in LB, and 86.1% in AR prelaminectomy and by 75.4% in F, 76% in E, 80.6% in LB, and 76.4% in AR postlaminectomy compared to intact (P < 0.05). Only in AR, PL constructs with HH connectors at C3 & C7, TL connectors at C4-C5 & C5-C6, and at C3-C4 & C6-C7 significantly reduced the range of motion by 12.9%, 11.9%, and 11.9%, respectively, compared to PL LMS (P < 0.05). No statistical significance was observed between TL connector and HH connector in all loading directions.
CONCLUSION
The biomechanical advantage of transverse connectors is significant in AR, when using two connectors at the proximal and distal ends, compared to one connector. In a clinical setting, this data may guide surgeons on transverse connector configurations to consider during posterior cervical instrumentation.
研究设计
一项体外生物力学研究，旨在探讨横联器对减压后路颈椎稳定系统的影响。
目的
评估颈椎后路长节段固定中横联器的最佳设计、数量和位置。
背景资料总结
在颈椎中，侧块螺钉（LMS）固定用于提供减压后的稳定性。横联器已被用于增强节段后路器械。然而，在颈椎区域，横联器的最佳设计、数量和位置尚不清楚。
方法
对 7 具新鲜的胸颈段人尸体脊柱（C2-T1）进行测试，施加±1.5 Nm 的屈伸（F）、伸展（E）、侧屈（LB）和轴向旋转（AR）力矩。在测试完整状态后，放置 LMS/杆，然后在多个节段，预减压（PL）和减压后，使用两种不同的横联器（顶载联器[TL]和对头联器[HH]）进行测试。
结果
LMS 在 PL 前和 PL 后分别使 F 向、E 向、LB 向和 AR 向的节段运动减少了 77.2%、75.6%、86.6%和 86.1%，与完整状态相比（P < 0.05）。仅在 AR 方向，C3 和 C7 处使用 HH 联器、C4-C5 和 C5-C6 处使用 TL 联器以及 C3-C4 和 C6-C7 处使用 TL 联器的 PL 构建体可使运动范围减少 12.9%、11.9%和 11.9%，与 PL LMS 相比（P < 0.05）。在所有加载方向，TL 联器与 HH 联器之间无统计学差异。
结论
与单联器相比，在 AR 方向，当在近端和远端使用两个联器时，横联器的生物力学优势显著。在临床环境中，这些数据可能会指导外科医生在进行后路颈椎固定时考虑横联器的配置。
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