S 型动力 cage 采用钛和 PEEK 材料对颈椎不同载荷下的 ACDF 手术的生物力学影响
The biomechanical effects of S-type dynamic cage using Ti and PEEK for ACDF surgery on cervical spine varying loads.
机构信息
Department of Mechanical Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Tamilnadu, India.
出版信息
Int J Artif Organs. 2021 Oct;44(10):748-755. doi: 10.1177/03913988211039525. Epub 2021 Aug 13.
Anterior cervical discectomy with fusion (ACDF) is the common method to treat the cervical disc degeneration. The most serious problems in the fusion cages are adjacent disc degeneration, loss of lordosis, pain, subsidence, and migration of the cage. The objective of our work is to develop the three-dimensional finite element (FE) model from C3-C6 and virtually implant a designed S-type dynamic cage at C4-C5 segment of the model. The dynamic cage design will provide mobility in the early stage after ACDF surgery. Titanium (Ti) and PEEK (polyether ether ketone) were used as the material property for the cages. We applied the physiological motions at different loads from 0.5, 1, 1.5, 2.0 Nm to evaluate the dynamic cage design and the biomechanical performances of the designed S-type dynamic cage. It was observed that in all the loading condition the range of motion in the adjacent level was maintained and the maximum stress at the adjacent disc was reduced. The clinical significance of the S-type dynamic cage is better stress profile at the fusion level and adjacent segments which translates into higher rate of fusion, lower risk of cage subsidence, lower risk of adjacent segment degeneration, and good mechanical stability.
颈椎前路椎间盘切除融合术 (ACDF) 是治疗颈椎间盘退变的常用方法。融合器最严重的问题是相邻椎间盘退变、前凸丢失、疼痛、下沉和迁移。我们的工作目标是从 C3-C6 建立三维有限元 (FE) 模型,并在模型的 C4-C5 节段虚拟植入设计的 S 型动力 cage。动力 cage 的设计将在 ACDF 手术后的早期提供活动度。钛 (Ti) 和聚醚醚酮 (PEEK) 被用作 cage 的材料特性。我们施加了不同载荷(0.5、1、1.5、2.0 Nm)下的生理运动,以评估动力 cage 的设计和 S 型动力 cage 的生物力学性能。结果观察到,在所有加载条件下,相邻节段的活动度保持不变,相邻椎间盘的最大应力降低。S 型动力 cage 的临床意义在于融合节段和相邻节段的应力分布更好,这意味着融合率更高, cage 下沉的风险更低,相邻节段退变的风险更低,机械稳定性更好。