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与传统背侧稳定术相比,采用新型单侧稳定技术固定腰椎骨折脱位后犬类尸体脊柱的弯曲强度和刚度。

Bending strength and stiffness of canine cadaver spines after fixation of a lumbar spinal fracture-luxation using a novel unilateral stabilization technique compared to traditional dorsal stabilization.

作者信息

Hall David A, Snelling Samuel R, Ackland David C, Wu Wenn, Morton John M

机构信息

Advanced Vetcare, Melbourne, Australia.

出版信息

Vet Surg. 2015 Jan;44(1):94-102. doi: 10.1111/j.1532-950X.2014.12268.x. Epub 2014 Sep 11.

Abstract

OBJECTIVE

To 1) assess the bending strength and stiffness of canine cadaver spines after fixation of a lumbar spinal fracture-luxation using a novel unilateral stabilization technique with pins and polymethyl methacrylate (PMMA) and 2) compare the results to a reference standard dorsal pin and PMMA technique.

STUDY DESIGN

A randomized non-inferiority trial.

SAMPLE POPULATION

Cadaveric lumbar spines (L1-L6) from 20 Greyhounds.

METHODS

Specimens were paired to match bodyweight and vertebral size. A standardized fracture/luxation was performed between L3 and L4. One spine within each pair was randomly assigned the unilateral fixation technique and the other received the reference standard dorsal fixation technique. Four-point bending of each specimen in flexion was performed by applying load to pins placed transversely into vertebrae L1, L2, L5, and L6. During testing, angular bending strength and stiffness were measured as a function of flexion angle. Margins for non-inferiority were defined a priori. Strength and stiffness of the specimens for each technique were compared statistically.

RESULTS

Lower limits of 95% confidence intervals were above the defined margins for non-inferiority. Thus, based on these margins, for strength and stiffness, unilateral fixation was not inferior to dorsal fixation.

CONCLUSIONS

This novel unilateral approach to lumbar spinal fixation yielded comparable strength and stiffness when tested for bending in flexion to that of reference standard dorsal approach. This approach is therefore a suitable alternative to the dorsal approach in appropriate lumbar spinal fracture configurations.

摘要

目的

1)使用新型单侧椎弓根钉联合聚甲基丙烯酸甲酯(PMMA)固定技术评估犬腰椎骨折脱位固定后脊柱的弯曲强度和刚度;2)将结果与参考标准的后路椎弓根钉联合PMMA技术进行比较。

研究设计

随机非劣效性试验。

样本

20只灵缇犬的尸体腰椎(L1-L6)。

方法

根据体重和椎体大小对标本进行配对。在L3和L4之间进行标准化骨折/脱位。每对中的一个脊柱随机采用单侧固定技术,另一个采用参考标准的后路固定技术。通过向横向插入L1、L2、L5和L6椎体的椎弓根钉施加负荷,对每个标本进行四点弯曲试验。在测试过程中,测量角弯曲强度和刚度作为屈曲角度的函数。非劣效性界限预先定义。对每种技术标本的强度和刚度进行统计学比较。

结果

95%置信区间的下限高于预先定义的非劣效性界限。因此,基于这些界限,在强度和刚度方面,单侧固定不劣于后路固定。

结论

这种新型的腰椎单侧固定方法在屈曲弯曲测试中产生的强度和刚度与参考标准的后路固定方法相当。因此,在适当的腰椎骨折情况下,这种方法是后路固定方法的合适替代方案。

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