In vitro biomechanical investigation of the stability and stress-shielding effect of lumbar interbody fusion devices
In vitro biomechanical investigation of the stability and stress-shielding effect of lumbar interbody fusion devices
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DOI：
10.3171/spi.2000.93.2.0259
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发表时间：
2000-10-01
影响因子：
4.1
通讯作者：
McAfee, PC
中科院分区：
文献类型：
--
作者：
Kanayama, M;Cunningham, BW;McAfee, PC
Object.椎间融合器作为一种确保腰椎椎间关节融合术的方法正在迅速获得认可。虽然已经开发了不同类型的器械，但重建稳定性的比较仍存在争议。目前还不清楚如何在设备内创建不同的应力屏蔽环境。本研究采用小腿脊柱模型，旨在比较II不同设计的腰椎椎间融合器的结构刚度，并通过测量器械内的压力来量化其应力遮挡效应。66个来自小腿的腰椎标本通过使用以下椎间融合器之一在L4-5进行前路椎间重建：4个不同的螺纹融合器（巴克器械、巴克Proximity、Ray TFC和Danek TIBFD），5种不同的非螺纹融合器械（椭圆形和圆形Harms融合器、Brantigan PLIF和ALIF融合器以及InFix器械）;使用了两种不同类型的同种异体移植物（股骨环和骨钉）。在轴向压缩、扭转、屈曲和侧弯条件下评价结构刚度。在测试之前，将硅弹性体注入融合器中，并使用压力针传感器测量融合器内压力。在大多数测试模式中，未观察到螺纹融合器和非螺纹器械之间的结构刚度存在统计学差异。与非螺纹椎间融合器和结构性同种异体移植物相比，螺纹椎间融合器显示出显著更低的椎间融合器内压。与非螺纹融合器和结构性同种异体移植物相比，螺纹融合器提供了等同的重建刚度，但在器械内提供了更多的应力屏蔽环境。
Object. Interbody fusion devices are rapidly gaining acceptance as a method of ensuring lumbar interbody arthrodesis. Although different types of devices have been developed, the comparative reconstruction stability remains controversial. It also remains unclear how different stress-shielded environments are created within the devices. Using a calf spine model, this study was designed to compare the construct stiffness afforded by II differently designed lumbar interbody fusion devices and to quantify their stress-shielding effects by measuring pressure within the devices.Methods. Sixty-six lumbar specimens obtained from calves were subjected to anterior interbody reconstruction at L4-5 by using one of the following interbody fusion devices: four different threaded fusion cages (BAK device, BAK Proximity, Ray TFC, and Danek TIBFD), five different nonthreaded fusion devices (oval and circular Harms cages, Brantigan PLIF and ALIF cages, and InFix device); two different types of allograft (femoral ring and bone dowel) were used. Construct stiffness was evaluated in axial compression, torsion, flexion, and lateral bending. Prior to testing, a silicon elastomer was injected into the cages and intracage pressures were measured using pressure needle transducers.Conclusions. No statistical differences were observed in construct stiffness among the threaded cages and nonthreaded devices in most of the testing modalities. Threaded fusion cages demonstrated significantly lower intracage pressures compared with nonthreaded cages and structural allografts. Compared with nonthreaded cages and structural allografts, threaded fusion cages afforded equivalent reconstruction stiffness but provided more stress-shielded environment within the devices.