Mizuno Tetsutaro, Sakakibara Toshihiko, Yoshikawa Takamasa, Inaba Tadashi, Kato Takaya, Kasai Yuichi
Department of Spinal Surgery and Medical Engineering, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Department of Mechanical Engineering, Graduate School of Engineering, Mie University, Tsu, Mie, Japan.
Med Sci Monit Basic Res. 2018 Jan 26;24:26-30. doi: 10.12659/msmbr.906339.
BACKGROUND Surgery with pedicle screw instrumentation does not provide sufficient torsional stability. This leads to pseudoarthrosis, loosening of the pedicle screws, and, ultimately, implant failure. MATERIAL AND METHODS Functional spinal units from 18 deer were evaluated using a 6-axis material testing machine. As specimen models, we prepared an intact model, a damaged model, a cross-rod model, and a cross-link model. We measured the range of motion (ROM) during bending and rotation tests. RESULTS The range of motions of cross-rod model were almost equal to those of cross-link model during the bending test. In the rotation test, the average ranges of motion of the intact, cross-rod, and cross-link models were 2.9°, 3.1°, and 3.9° during right rotation and 2.9°, 3.1°, and 4.1° during left rotation, respectively. The range of motions of the cross-rod model were significantly smaller than those of the cross-link model during the rotation test. The range of motions of the intact model were significantly smaller than those of the cross-link model during the rotation test, but there were no statistically significant differences between the range of motions of intact model and cross-rod model during the rotation test. CONCLUSIONS The stability of spinal fixation such as cross-rod model is equal to the fixation using the pedicle screw system during bending tests and equal to that of the intact spine during rotation tests.
背景 椎弓根螺钉内固定手术无法提供足够的扭转稳定性。这会导致假关节形成、椎弓根螺钉松动,并最终导致植入物失败。
材料与方法 使用六轴材料试验机对18只鹿的功能性脊柱单元进行评估。作为标本模型,我们制备了完整模型、损伤模型、横杆模型和交联模型。我们在弯曲和旋转测试中测量了运动范围(ROM)。
结果 在弯曲测试中,横杆模型的运动范围与交联模型几乎相等。在旋转测试中,完整模型、横杆模型和交联模型在右旋时的平均运动范围分别为2.9°、3.1°和3.9°,左旋时分别为2.9°、3.1°和4.1°。在旋转测试中,横杆模型的运动范围明显小于交联模型。在旋转测试中,完整模型的运动范围明显小于交联模型,但完整模型和横杆模型在旋转测试中的运动范围之间没有统计学上的显著差异。
结论 诸如横杆模型之类的脊柱固定稳定性在弯曲测试中与使用椎弓根螺钉系统的固定相当,在旋转测试中与完整脊柱的稳定性相当。