Benditz A, Auer S, Spörrer J F, Wolkerstorfer S, Grifka J, Suess F, Dendorfer S
Department of Orthopaedics, University Medical Centre Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany.
Laboratory for Biomechanics, Regensburg Center of Biomedical Engineering, Galgenbergstrasse 30, 93053, Regensburg, Germany.
Eur Spine J. 2018 Aug;27(8):1905-1910. doi: 10.1007/s00586-018-5476-5. Epub 2018 Jan 19.
The number of spinal fusion surgeries is steadily increasing and biomechanical consequences are still in debate. The aim of this study is to provide biomechanical insights into the sagittal balance of the spine and to compare spinal load before and after spinal fusion.
The joint reaction forces of 52 patients were analyzed in proximo-distal and antero-posterior direction from the levels T12-L1 to L5-S1 using musculoskeletal simulations.
In 104 simulations, pre-surgical forces were equal to post-surgical. The levels L4-L5 and T12-L1, however, showed increased spinal forces compression forces with higher sagittal displacement. Improved restauration of sagittal balance was accompanied by lower spinal load. AP shear stress, interestingly decreased with sagittal imbalance.
Imbalanced spines have a risk of increased compression forces at Th12-L1. L4-L5 always has increased spinal loads. These slides can be retrieved under Electronic Supplementary Material.
脊柱融合手术的数量在稳步增加，其生物力学后果仍存在争议。本研究的目的是提供有关脊柱矢状面平衡的生物力学见解，并比较脊柱融合前后的脊柱负荷。
使用肌肉骨骼模拟，从T12-L1至L5-S1水平在近端-远端和前后方向分析了52例患者的关节反作用力。
在104次模拟中，术前力与术后力相等。然而，L4-L5和T12-L1水平显示，随着矢状面位移增加，脊柱压力增加。矢状面平衡的改善伴随着脊柱负荷的降低。有趣的是，前后剪切应力随着矢状面不平衡而降低。
脊柱失衡有导致T12-L1水平压力增加的风险。L4-L5水平的脊柱负荷总是增加。这些幻灯片可在电子补充材料中获取。
