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一种弹性可变形颈椎植入物的力学性能。

Mechanical properties of an elastically deformable cervical spine implant.

机构信息

Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Rd., Chengdu, China.

Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.

出版信息

J Orthop Surg Res. 2023 Aug 16;18(1):605. doi: 10.1186/s13018-023-04042-7.

Abstract

Anterior cervical surgery is widely accepted and time-tested surgical procedure for treating cervical radiculopathy and myelopathy. However, there is concern about the high adjacent segment degeneration rate and implant subsidence after the surgery using the traditional polyetheretherketone cage. Thus, we creatively designed a polyurethane cervical implant that can continuous load-sharing through elastic deformation and decrease postoperative stress concentration at adjacent segments. In this study, the design rationality and safety of this novel implant was evaluated based on several mechanical parameters including compression test, creeping test, push-out test and subsidence test. The results showed that the novel cervical implant remained intact under the compressive axial load of 8000 N and continues to maintained the elastic deformation phase. The minimum push-out load of the implant was 181.17 N, which was significantly higher than the maximum compressive shear load of 20 N experienced by a normal human cervical intervertebral disc. Besides, the creep recovery behaviour of the implant closely resembled what has been reported for natural intervertebral discs and clinically applied cervical devices in literature. Under the load of simulating daily activities of the cervical spine, the implant longitudinal displacement was only 0.54 mm. In conclusion, this study showed that the current design of the elastically deformable implant was reasonable and stable to fulfil the mechanical requirements of a cervical prosthesis under physiological loads. After a more comprehensive understanding of bone formation and stress distribution after implantation, this cervical implant is promising to be applied to certain patients in clinical practice.

摘要

颈椎前路手术是治疗神经根型颈椎病和脊髓型颈椎病的一种广泛接受且经过时间验证的手术方法。然而,人们对使用传统聚醚醚酮 cage 进行手术后相邻节段退变率高和植入物下沉的问题仍存在担忧。因此,我们创造性地设计了一种聚氨酯颈椎植入物,它可以通过弹性变形连续分担负荷,并降低术后相邻节段的应力集中。在这项研究中,我们基于几项机械参数,包括压缩试验、蠕变试验、推出试验和下沉试验,评估了这种新型植入物的设计合理性和安全性。结果表明,新型颈椎植入物在 8000N 的轴向压缩载荷下保持完整,并持续保持弹性变形阶段。植入物的最小推出载荷为 181.17N,明显高于正常人颈椎椎间盘所经历的最大压缩剪切载荷 20N。此外,植入物的蠕变恢复行为与文献中报道的天然椎间盘和临床应用的颈椎器械非常相似。在模拟颈椎日常活动的载荷下,植入物的纵向位移仅为 0.54mm。总之,本研究表明,目前弹性变形植入物的设计合理且稳定,能够满足生理负荷下颈椎假体的机械要求。在对植入后骨形成和应力分布有更全面的了解后,这种颈椎植入物有望在临床实践中应用于某些患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/460c/10428533/6f4dad4df609/13018_2023_4042_Fig1_HTML.jpg

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