Effect of position and height of a mobile core type artificial disc on the biomechanical behaviour of the lumbar spine
Effect of position and height of a mobile core type artificial disc on the biomechanical behaviour of the lumbar spine
复制标题
移动核心式人工椎间盘位置和高度对腰椎生物力学行为的影响
DOI：
10.1243/09544119jeim241
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
G. Bergmann
中科院分区：
文献类型：
--
作者：
A. Rohlmann;T. Zander;B. Bock;G. Bergmann
摘要研究了自然椎间盘切除的程度、带移动的核的人工椎间盘的植入位置和高度对节段间旋转、椎间盘内压力和小关节力的影响。使用经确认的腰椎有限元模型。该模型承受上身重量、跟随载荷和肌肉力，以模拟站立、屈曲、伸展、侧弯和轴向旋转。植入物位置在前后方向上变化最多2 mm，在横向方向上变化最多3 mm。模拟了三种不同的植入物高度。还研究了去除瓣环侧面部分的效果。植入物的位置和高度显著影响节段间旋转和小关节力，但对相邻椎间盘的椎间盘内压力几乎没有任何影响。去除环的外侧部分增加了节段间的旋转和小关节的力，主要是侧弯和轴向旋转。移动的种植体核心的计算平移最多约为1 mm，因此其效果通常被高估。应非常小心地选择最佳种植体高度，并将种植体插入每个患者的最佳位置。
Abstract The extent of natural disc removal and the implant position and height of an artificial disc with a mobile core were studied for their effects on intersegmental rotation, intradiscal pressure, and facet joint force. A validated finite element model of the lumbar spine was used. The model was loaded with the upper body weight, a follower load, and muscle forces to simulate standing, flexion, extension, lateral bending, and axial rotation. The implant position was varied up to 2 mm in an anterior and posterior direction and up to 3 mm in a lateral direction. Three different implant heights were simulated. The effect of removing the lateral parts of the annulus was also studied. The implant position and height markedly affect intersegmental rotation and facet joint forces but have hardly any influence on intradiscal pressure in the adjacent discs. Removing the lateral parts of the annulus increases intersegmental rotation and facet joint force mainly for lateral bending and axial rotation. The calculated translation of the mobile implant core is about 1 mm at most, and thus its effect is often overestimated. Great care should be taken to choose the optimal implant height and to insert the implant in the best position for each individual patient.