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固定腰椎脊柱内固定时瞬时旋转轴的轨迹

Trajectory of instantaneous axis of rotation in fixed lumbar spine with instrumentation.

作者信息

Inoue Masataka, Mizuno Tetsutaro, Sakakibara Toshihiko, Kato Takaya, Yoshikawa Takamasa, Inaba Tadashi, Kasai Yuichi

机构信息

Department of Mechanical Engineering, Graduate School of Engineering, Mie University, 1577 Kurimamachiya-cho, Tsu City, 514-8507, Mie prefecture, Japan.

Department of Spinal Surgery and Medical Engineering, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, 514-8507, Mie prefecture, Japan.

出版信息

J Orthop Surg Res. 2017 Nov 16;12(1):177. doi: 10.1186/s13018-017-0677-x.

Abstract

BACKGROUND

Several studies showed instantaneous axis of rotation (IAR) in the intact spine. However, there has been no report on the trajectory of the IAR of a damaged spine or that of a fixed spine with instrumentation. It is the aim of this study to investigate the trajectory of the IAR of the lumbar spine using the vertebra of deer.

METHODS

Functional spinal units (L5-6) from five deer were evaluated with six-axis material testing machine. As specimen models, we prepared a normal model, a damaged model, and a pedicle screw (PS) model. We measured the IAR during bending in the coronal and sagittal planes and axial rotation. In the bending test, four directions were measured: anterior, posterior, right, and left. In the rotation test, two directions were measured: right and left.

RESULTS

The IAR of the normal model during bending moved in the bending direction. The IAR of the damaged model during bending moved in the bending direction, but the magnitude of displacement was bigger compared to that of the normal model. In the PS model, the IAR during bending test hardly moved. During rotation test, the IAR of the normal model and PS model located in the spinal canal, but the IAR of the damaged model located in the posterior part of the vertebral body.

CONCLUSIONS

In this study, the IAR of damaged model was scattering and that of PS model was concentrating. This suggests that higher mechanical load applied to the dura tube and nerve roots in the damaged model and less mechanical load applied to that in the PS model.

摘要

背景

多项研究显示了完整脊柱的瞬时旋转轴(IAR)。然而,关于受损脊柱或使用内固定器械固定的脊柱的IAR轨迹尚无报道。本研究的目的是使用鹿的椎骨来研究腰椎的IAR轨迹。

方法

使用六轴材料试验机对五只鹿的功能性脊柱单元(L5 - 6)进行评估。作为标本模型,我们制备了正常模型、受损模型和椎弓根螺钉(PS)模型。我们测量了在冠状面和矢状面弯曲以及轴向旋转过程中的IAR。在弯曲试验中,测量了四个方向:前、后、右和左。在旋转试验中,测量了两个方向:右和左。

结果

正常模型在弯曲过程中的IAR沿弯曲方向移动。受损模型在弯曲过程中的IAR也沿弯曲方向移动,但与正常模型相比,位移幅度更大。在PS模型中,弯曲试验期间的IAR几乎不移动。在旋转试验中,正常模型和PS模型的IAR位于椎管内,但受损模型的IAR位于椎体后部。

结论

在本研究中,受损模型的IAR分散,而PS模型的IAR集中。这表明受损模型中硬脊膜管和神经根承受的机械负荷较高,而PS模型中承受的机械负荷较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6303/5689179/990d4d7085d3/13018_2017_677_Fig1_HTML.jpg

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