Cook Daniel J, Yeager Matthew S, Thampi Shankar S, Whiting Donald M, Cheng Boyle C
Allegheny Health Network, Department of Neurosurgery, Pittsburgh, PA.
Drexel University College of Medicine, Pittsburgh, PA.
Int J Spine Surg. 2015 Mar 30;9:9. doi: 10.14444/2009. eCollection 2015.
Lumbar interbody fusion is a common treatment for a variety of spinal pathologies. It has been hypothesized that insufficient mechanical loading of the interbody graft can prevent proper fusion of the joint. The purpose of this study was to evaluate the mechanical stability and anterior column loading sharing characteristics of a posterior dynamic system compared to titanium rods in an anterior lumbar interbody fusion (ALIF) model.
Range of motion, interpedicular kinematics and interbody graft loading were measured in human cadaveric lumbar segments tested under a pure moment flexibility testing protocol.
Both systems provided significant fixation compared to the intact condition and to an interbody spacer alone in flexion extension and lateral bending. No significant differences in fixation were detected between the devices. A significant decrease in graft loading was detected in flexion for the titanium rod treatment compared to spacer alone. No significant differences in graft loading were detected between the spacer alone and posterior dynamic system or between the posterior dynamic system and the titanium rod.
The results of this study indicate that the posterior dynamic system provides similar fixation compared to that of a titanium rod, however, studies designed to evaluate the efficacy of fixation in a cadaver model may not be sufficiently powered to establish differences in load sharing using the techniques described here.
腰椎椎间融合术是治疗多种脊柱疾病的常用方法。据推测,椎间融合器的机械负荷不足会阻碍关节的正常融合。本研究的目的是在腰椎前路椎间融合(ALIF)模型中,评估一种后路动力系统与钛棒相比的机械稳定性和前柱负荷分担特征。
在人体尸体腰椎节段上,按照纯力矩柔韧性测试方案进行测试,测量其活动范围、椎弓根间运动学和椎间融合器负荷。
与完整状态以及单独使用椎间融合器相比,两种系统在屈伸和侧方弯曲时均提供了显著的固定效果。两种装置之间未检测到固定效果的显著差异。与单独使用椎间融合器相比,钛棒治疗在屈曲时检测到融合器负荷显著降低。单独使用椎间融合器与后路动力系统之间或后路动力系统与钛棒之间未检测到融合器负荷的显著差异。
本研究结果表明,后路动力系统与钛棒提供的固定效果相似,然而,旨在评估尸体模型中固定效果的研究可能没有足够的效力,无法使用此处描述的技术确定负荷分担的差异。