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新型侧方钢板内固定物稳定性的评估:一项体外生物力学研究。

Evaluation of the Stability of a Novel Lateral Plate Internal Fixation: An In Vitro Biomechanical Study.

机构信息

Ningxia Medical University, Yinchuan, Ningxia, China.

Department of Orthopedics, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.

出版信息

World Neurosurg. 2022 Feb;158:e237-e244. doi: 10.1016/j.wneu.2021.10.164. Epub 2021 Oct 30.

Abstract

BACKGROUND

This study aims to evaluate the biomechanical stability of a novel lateral plate (NLP) that can be used in oblique lateral lumbar fusion (OLIF).

METHODS

In vitro biomechanical tests were performed on 6 fresh calf lumbar vertebrae specimens. The surgical segment was set at L3-L4. Each specimen was tested in the following order: intact state (INT); OLIF cage only/stand-alone (SA); cage supplemented with lateral screw-rod (LSR); cage supplemented with novel lateral plate (NLP); and cage supplemented with unilateral or bilateral pedicle screw-rod (UPS or BPS). A pure moment of ±7.5 Nm was applied to the specimen to produce 6 different motion directions, including flexion and extension, lateral bending, and axial rotation, and the range of motion (ROM) of L3-L4 in each direction was recorded.

RESULTS

In addition to flexion-extension, NLP reduced the ROM of SA (P < 0.05). In flexion-extension, the ROM of NLP was similar to those of SA and LSR (P > 0.05); compared to pedicle screw-rod (PSD), the ROM of NLP was higher (P < 0.05). In lateral bending, the ROM of NLP was close to that of LSR and PSD (P > 0.05). In axial rotation, the ROM of NLP was higher than that of PSD (P < 0.05), and close to that of LSR (P > 0.05).

CONCLUSIONS

NLP can enhance surgical segment stability in all directions of motion, similar to LSR, but weaker than UPS and BPS in flexion-extension and rotation.

摘要

背景

本研究旨在评估一种新型侧板(NLP)在斜外侧腰椎融合术(OLIF)中的生物力学稳定性。

方法

对 6 个新鲜小牛腰椎标本进行体外生物力学测试。手术节段设置在 L3-L4。每个标本按以下顺序进行测试:完整状态(INT);OLIF 笼仅/独立(SA);笼补充侧螺钉-棒(LSR);笼补充新型侧板(NLP);笼补充单侧或双侧椎弓根螺钉-棒(UPS 或 BPS)。在标本上施加±7.5 Nm 的纯扭矩,产生 6 个不同的运动方向,包括屈伸、侧屈和轴向旋转,并记录每个方向 L3-L4 的活动范围(ROM)。

结果

除屈伸外,NLP 降低了 SA 的 ROM(P < 0.05)。在屈伸时,NLP 的 ROM 与 SA 和 LSR 相似(P > 0.05);与椎弓根螺钉-棒(PSD)相比,NLP 的 ROM 更高(P < 0.05)。在侧屈时,NLP 的 ROM 接近 LSR 和 PSD(P > 0.05)。在轴向旋转时,NLP 的 ROM 高于 PSD(P < 0.05),接近 LSR(P > 0.05)。

结论

NLP 可以增强手术节段在所有运动方向的稳定性,与 LSR 相似,但在屈伸和旋转方面弱于 UPS 和 BPS。

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