Assessing the biofidelity of in vitro biomechanical testing of the human cervical spine.
Assessing the biofidelity of in vitro biomechanical testing of the human cervical spine.
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人体颈椎体外生物力学测试的生物逼真度评估。
DOI：
10.1002/jor.24702
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Bell KM
中科院分区：
文献类型：
--
作者：
Wawrose RA;Howington FE;LeVasseur CM;Smith CN;Couch BK;Shaw JD;Donaldson WF;Lee JY;Patterson CG;Anderst WJ;Bell KM
骨少根性脊柱的体外生物力学研究被广泛用于表征正常生物力学，确定损伤机制，评估退变和手术器械对脊柱力学的影响。本研究的目的是确定四种标准的体外加载模式在与瞬时旋转中心和关节运动学相关的椎间盘变形方面如何很好地复制体内运动学。先前收集了20名无症状参与者（45.5±5.8岁）的体内数据，这些参与者在双翼x线系统下进行了全范围的颈部屈伸活动。使用经过验证的基于模型的跟踪过程以亚毫米精度确定椎间运动学。在机器人测试系统中测试了10个尸体脊柱（51.8±7.3年）的屈伸。每个试件在纯弯矩、轴向加载、从动件加载和组合加载四种加载条件下进行了测试。直接比较体内和体外骨运动数据。在所有水平的四种负荷模式下，体外ICR的平均水平显著增加。一般情况下，体外模型椎间盘前后高度均大于体内模型。然而，在调整性别后，观察到的椎间盘高度差异无统计学意义。这一数据表明，单独的体外生物力学测试可能无法复制体内条件，这对新型运动保存装置（如颈椎间盘置换术植入物）具有重要意义。
In vitro biomechanical studies of the osteoligamentous spine are widely used to characterize normal biomechanics, identify injury mechanisms, and assess the effects of degeneration and surgical instrumentation on spine mechanics. The objective of this study was to determine how well four standard in vitro loading paradigms replicate in vivo kinematics with regards to the instantaneous center of rotation and arthrokinematics in relation to disc deformation. In vivo data was previously collected from 20 asymptomatic participants (45.5 ± 5.8 years) who performed full range of motion neck flexion-extension within a biplane x-ray system. Intervertebral kinematics were determined with sub-millimeter precision using a validated model-based tracking process. Ten cadaveric spines (51.8 ± 7.3 years) were tested in flexion-extension within a robotic testing system. Each specimen was tested under four loading conditions: pure moment, axial loading, follower loading, and combined loading. The in vivo and in vitro bone motion data were directly compared. The average in vitro ICR was significantly more anterior in all four loading paradigms for all levels. In general, the anterior and posterior disc heights were larger in the in vitro models than in vivo. However, after adjusting for gender, the observed differences in disc height were not statistically significant. This data suggests that in vitro biomechanical testing alone may fail to replicate in vivo conditions, with significant implications for novel motion preservation devices such as cervical disc arthroplasty implants.
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