Mannen Erin M, Arnold Paul M, Anderson John T, Friis Elizabeth A
Department of Mechanical Engineering, University of Kansas, 1530 W 15th St., Learned Hall Room 3138, Lawrence, KS 66045, USA.
Department of Neurosurgery, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
Spine Deform. 2017 Mar;5(2):91-96. doi: 10.1016/j.jspd.2016.10.004.
Biomechanical cadaveric study.
The purpose of this study was to determine the change in range of motion (ROM) of the human thoracic spine and rib cage due to sequential Ponte osteotomies (POs).
POs are often performed in deformity correction surgeries to provide flexibility in the sagittal plane at an estimated correction potential of 5° per PO, but no studies have evaluated the biomechanical impact of the procedure on a cadaveric model with an intact rib cage.
Seven human thoracic cadavers with intact rib cages were loaded with pure moments in flexion, extension, axial rotation, and lateral bending for five conditions: intact, PO at T9-T10, PO at T8-T9, PO at T7-T8, and PO at T6-T7. Motion of T1, T6, and T10 were measured, and overall (T1-T12) and regional (T6-T10) ROMs were reported for each mode of bending at each condition.
POs increased ROM in flexion both overall (T1-T12) and regionally (T6-T10), although the magnitude of the increase was marginal (<1°/PO). No significant differences were found in axial rotation or lateral bending.
POs may increase sagittal correction potential before fusion in patients with hyperkyphosis, though more work should be done to determine the magnitude of the changes.
Level V.
生物力学尸体研究。
本研究旨在确定连续的庞特截骨术（PO）对人体胸椎和胸廓活动范围（ROM）的影响。
PO常用于畸形矫正手术，以在矢状面提供灵活性，估计每个PO的矫正潜力为5°，但尚无研究评估该手术对具有完整胸廓的尸体模型的生物力学影响。
对7具胸廓完整的人类胸椎尸体进行以下5种情况下的纯弯矩加载：屈曲、伸展、轴向旋转和侧方弯曲，5种情况分别为：完整状态、T9 - T10节段PO、T8 - T9节段PO、T7 - T8节段PO和T6 - T7节段PO。测量T1、T6和T10的运动，并报告每种情况下每种弯曲模式的整体（T1 - T12）和局部（T6 - T10）ROM。
PO使整体（T1 - T12）和局部（T6 - T10）的屈曲ROM增加，尽管增加幅度较小（<1°/PO）。在轴向旋转或侧方弯曲方面未发现显著差异。
对于后凸畸形患者，PO可能会增加融合前矢状面的矫正潜力，不过还需要更多研究来确定变化的幅度。
V级。
