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一种新型动态生长棒的设计与力学评估,以改善早发性脊柱侧弯的手术治疗

Design and mechanical evaluation of a novel dynamic growth rod to improve the surgical treatment of early-onset scoliosis.

作者信息

Xu Yangyang, Wu Xueqing, Lu Da, Wu Yong, Li Heng, Pei Baoqing

机构信息

Beijing Key Laboratory for Design and Evaluation Technology of Advanced Implantable & Interventional Medical Devices, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.

Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Changzhi People's Hospital, Changzhi, China.

出版信息

Bone Joint Res. 2025 Sep 1;14(9):747-759. doi: 10.1302/2046-3758.149.BJR-2024-0280.R3.

Abstract

AIMS

Growth rods are the gold standard for treating early-onset scoliosis (EOS), but current treatments often fail to optimally promote spinal growth and require frequent distraction surgeries, leading to complications and significant burdens on patients.

METHODS

We designed a novel growth rod (NGR) with unidirectional sliding and external regulation capabilities. Using a 3D model, we simulated the implantation of traditional growth rod (TGR) and NGR, applying a 400 N compressive load and a 1 Nm moment to test stiffness. We assessed spinal joint range of motion and growth rod stress distribution, and calculated axial force, moment, and fatigue life.

RESULTS

The axial compressive and torsional stiffness of the NGR were higher than those of the TGR and the intact group. The Von Mises stress values of the NGR under all conditions were higher than those of the TGR. Additionally, the fatigue life of the NGR met basic daily living requirements. Overall, the NGR demonstrated superior stiffness and stress distribution, with stress primarily concentrated near the screw fixation points and distributed along the titanium rods.

CONCLUSION

The NGR, based on a distraction implant, includes a unidirectional sliding component and a spring-driven component, providing dynamic correction functionality. Additionally, it features a novel non-invasive lengthening mechanism that reduces the risk of infection. Compared to the current market-leading EOS implants, it offers enhanced stability. The novel device can potentially improve clinical outcomes in the surgical treatment of EOS.

摘要

目的

生长棒是治疗早发性脊柱侧凸(EOS)的金标准,但目前的治疗方法往往无法最佳地促进脊柱生长,且需要频繁的撑开手术,导致并发症并给患者带来巨大负担。

方法

我们设计了一种具有单向滑动和外部调节功能的新型生长棒(NGR)。使用三维模型,我们模拟了传统生长棒(TGR)和NGR的植入过程,施加400 N的压缩载荷和1 Nm的力矩来测试刚度。我们评估了脊柱关节活动范围和生长棒应力分布,并计算了轴向力、力矩和疲劳寿命。

结果

NGR的轴向压缩刚度和扭转刚度高于TGR和完整组。在所有条件下,NGR的冯·米塞斯应力值均高于TGR。此外,NGR的疲劳寿命满足基本日常生活要求。总体而言,NGR表现出卓越的刚度和应力分布,应力主要集中在螺钉固定点附近并沿钛棒分布。

结论

基于撑开植入物的NGR包括单向滑动组件和弹簧驱动组件,提供动态矫正功能。此外,它具有一种新型的非侵入性延长机制,可降低感染风险。与当前市场领先的EOS植入物相比,它具有更高的稳定性。这种新型装置有可能改善EOS手术治疗的临床效果。

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