Gurr K R, McAfee P C, Warden K E, Shih C M
Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Orthop Res. 1989;7(6):838-48. doi: 10.1002/jor.1100070610.
An animal model of anterior and posterior column instability was developed to allow in vivo observation of bone remodeling and arthrodesis after spinal instrumentation. Various combinations of spinal fusions and instrumentation procedures were performed after an initial anterior and posterior destabilizing lesion was created at the L5-L6 vertebral levels in 35 adult beagles. After 6 months of postoperative observation, there was improved probability of achieving a spinal fusion if spinal instrumentation had been used. All biomechanical testing was performed after removal of instrumentation to test the inherent stiffnesses and quality of the spinal fusions. The fusions performed in conjunction with instrumentation (group V = Harrington instrumentation and posterolateral fusion; group VI = Luque instrumentation and posterolateral fusion) demonstrated the greatest axial rotation stiffnesses (group V, p less than .05); axial compressive stiffness (group V, p less than .05); and flexural stiffness (group VI, p less than .05). The results show that a spinal fusion can be more reliably achieved and will be more rigid if it is accompanied by spinal instrumentation.
构建了一种脊柱前后柱不稳定的动物模型,以便在体内观察脊柱内固定术后的骨重塑和关节融合情况。在35只成年比格犬的L5-L6椎体水平制造初始的前后侧不稳定损伤后,进行了各种脊柱融合和内固定手术的组合。术后观察6个月后发现,使用脊柱内固定时实现脊柱融合的可能性更高。所有生物力学测试均在移除内固定后进行,以测试脊柱融合的固有刚度和质量。与内固定联合进行的融合术(V组 = 哈灵顿内固定和后外侧融合;VI组 = 鲁克内固定和后外侧融合)表现出最大的轴向旋转刚度(V组,p < 0.05);轴向压缩刚度(V组,p < 0.05);以及弯曲刚度(VI组,p < 0.05)。结果表明,如果伴有脊柱内固定,脊柱融合可以更可靠地实现,并且会更坚固。