Advanced Multi-Axis Spine Testing: Clinical Relevance and Research Recommendations
Advanced Multi-Axis Spine Testing: Clinical Relevance and Research Recommendations
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高级多轴脊柱测试：临床相关性和研究建议
DOI：
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
B. Winkelstein
中科院分区：
文献类型：
--
作者：
T. Holsgrove;N. Nayak;W. Welch;B. Winkelstein
背痛和脊柱退化影响很大一部分人群。脊柱退行性变的经济负担是巨大的，脊柱退行性变的治疗占医疗保健费用的很大一部分。然而，与非手术替代方案相比，脊柱手术并不总能提供改善的临床结果，并且现代干预措施（例如全椎间盘置换术）可能无法比更成熟的手术提供临床相关的改善。尽管心理和社会经济因素在背痛的发生和反应中发挥着重要作用，但临床成功的差异也与脊柱的复杂性以及脊柱退变经常发生的多方面方式有关。退行性脊柱疾病的成功手术治疗需要外科医生、工程师和科学家之间的合作，以便提供多学科方法来管理整个疾病。在这篇综述中，我们从临床和基础研究的角度提供了相关背景，并将其综合为几个例子和建议，供考虑增加社区之间的转化研究，以提供改进的知识和护理。当前的临床成像和多轴测试机通过将体内运动学和负载与六个自由度的体外测试相结合，为未来的研究提供了广阔的前景，从而对新型脊柱器械的性能提供更准确的预测。综合文献后，建议体外测试力求尽可能多地重现体内环境，并且生理预载是实验室评估脊柱生物力学的关键因素。在体内和体外环境中都应考虑外科手术与所有三个解剖平面的结果之间更大的联系，以提供与运动质量和稳定性相关的数据。
Back pain and spinal degeneration affect a large proportion of the general population. The economic burden of spinal degeneration is significant, and the treatment of spinal degeneration represents a large proportion of healthcare costs. However, spinal surgery does not always provide improved clinical outcomes compared to non-surgical alternatives, and modern interventions, such as total disc replacement, may not offer clinically relevant improvements over more established procedures. Although psychological and socioeconomic factors play an important role in the development and response to back pain, the variation in clinical success is also related to the complexity of the spine, and the multi-faceted manner by which spinal degeneration often occurs. The successful surgical treatment of degenerative spinal conditions requires collaboration between surgeons, engineers, and scientists in order to provide a multi-disciplinary approach to managing the complete condition. In this review, we provide relevant background from both the clinical and the basic research perspectives, which is synthesized into several examples and recommendations for consideration in increasing translational research between communities with the goal of providing improved knowledge and care. Current clinical imaging, and multi-axis testing machines, offer great promise for future research by combining invivo kinematics and loading with in-vitro testing in six degrees of freedom to offer more accurate predictions of the performance of new spinal instrumentation. Upon synthesis of the literature, it is recommended that in-vitro tests strive to recreate as many aspects of the in-vivo environment as possible, and that a physiological preload is a critical factor in assessing spinal biomechanics in the laboratory. A greater link between surgical procedures, and the outcomes in all three anatomical planes should be considered in both the in-vivo and in-vitro settings, to provide data relevant to quality of motion, and stability.
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影响因子：
2.4
作者：
Gardner-Morse, MG;Stokes, IAF
通讯作者：
Stokes, IAF
影响因子：
120.7
作者：
Deyo, Richard A.;Mirza, Sohail K.;Martin, Brook I.;Kreuter, William;Goodman, David C.;Jarvik, Jeffrey G.
通讯作者：
Jarvik, Jeffrey G.
影响因子：
2.4
作者：
Baillargeon E;Anderst WJ
通讯作者：
Anderst WJ
DOI：
10.1115/1.4004493
发表时间：
2011-07-01
影响因子：
1.7
作者：
Jaumard, Nicolas V.;Welch, William C.;Winkelstein, Beth A.
通讯作者：
Winkelstein, Beth A.
影响因子：
2.4
作者：
Stokes, IA;Gardner-Morse, M;Laible, JP
通讯作者：
Laible, JP