Wittenberg R H, Shea M, Krämer J, Hayes W C
Orthopädische Universitätsklinik, St. Josef-Hospital, Bochum.
Z Orthop Ihre Grenzgeb. 1995 Mar-Apr;133(2):123-9. doi: 10.1055/s-2008-1039425.
The implantation of fixation devices increases the primary stability after surgery significantly. Little is known about the comparison of flexibility of instrumented and posterolateral fusions or the lumbosacral distractions spondylodesis (LSDS). The purpose of the study was to compare the flexibility of instrumented and posterolateral fusions or LSDS after simulation with polymethylmethacrylate (PMMA). Dynamic testing from 0-16 Nm in flexion/compression and 0-900 N in compression was performed on 14 lumbosacral spines. The spines were tested intact, after laminectomy, instrumentation with an internal fixateur L5-S1, and simulation of posterolateral fusion L4-S1 or LSDS and thereafter a pseudoarthrosis was simulated. The laminectomy resulted in a significant increase of flexibility and posterior distraction in flexion and compression. The stabilization with an internal fixateur or PMMA simulation for posterolateral fusion or LSDS resulted in a significant decrease of the flexibility. Creation of a unilateral pseudoarthrosis did not effect the flexibility. The instrumented fusion as well as the PMMA simulated bony posterolateral fusion and LSDS resulted in this model in a significant stabilization of the laminectomy. After unilateral fusion the flexibility was not significantly increased.
固定装置的植入显著提高了术后的初始稳定性。关于器械辅助融合与后外侧融合或腰骶部撑开性脊柱融合术（LSDS）的灵活性比较，人们了解甚少。本研究的目的是比较在使用聚甲基丙烯酸甲酯（PMMA）模拟后，器械辅助融合与后外侧融合或LSDS的灵活性。对14个腰骶椎进行了从0至16牛米的屈伸/压缩动态测试以及0至900牛的压缩测试。测试了完整脊柱、椎板切除术后、使用L5-S1内固定器进行器械固定后、模拟L4-S1后外侧融合或LSDS，之后模拟假关节的情况。椎板切除术导致屈伸和压缩时灵活性及后撑开显著增加。使用内固定器或PMMA模拟后外侧融合或LSDS进行固定导致灵活性显著降低。形成单侧假关节对灵活性没有影响。在该模型中，器械辅助融合以及PMMA模拟的骨性后外侧融合和LSDS导致椎板切除术得到显著稳定。单侧融合后灵活性没有显著增加。
