Increase or decrease in stability after nucleotomy? Conflicting in vitro and in vivo results in the sheep model
Increase or decrease in stability after nucleotomy? Conflicting in vitro and in vivo results in the sheep model
复制标题
核切除术后稳定性增加还是减少？
DOI：
10.1098/rsif.2014.0650
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发表时间：
2014
影响因子：
3.9
通讯作者：
Ignatius A
中科院分区：
文献类型：
--
作者：
Reitmaier S;Volkheimer D;Berger-Roscher N;Wilke H-J;Ignatius A
髓核切开术是治疗椎间盘突出的一种常见手术。然而，术后可能发生节段性不稳定，怀疑需要再次手术和融合。尽管体外研究支持核切除术后不稳定的理论，但先前的内部动物研究相反地显示手术后稳定性增加。为了确定运动节段的哪个结构区室是决定性的，以增加体内核切除术后的稳定性，羊运动节段的灵活性进行了测量后，在不同的逐步减少在前和后脊柱。分别在体内和体外条件下进行了不同的试验组，其中手术期间进行了核切除术。按照预期，在体外核切开术对绵羊运动节段显着增加的灵活性。相比之下，髓核切除术在术后12周显著降低了柔韧性。然而，在去除后部结构后，灵活性的差异减小了。因此，目前的结果表明，它可能不完全是在手术过程中的椎间盘创伤，这是决定性的术后稳定性，而是在后方结构的适应机制。因此，在手术过程中应注意尽量减少对后部结构的损伤，因为这更有可能损害稳定性。
Nucleotomy is a common surgical procedure to treat disc herniations. The potential occurrence of segmental instability after surgery, however, is suspected to necessitate re-operation and fusion. Althoughin vitrostudies support the theory of destabilization after nucleotomy, a prior, in-house animal study contrarily revealed an increase in stability after surgery. To identify which structural compartment of the motion segment is decisive for increased stability after nucleotomyin vivo, the flexibilities of ovine motion segments were measured after different stepwise reductions at the anterior and posterior spinal column. Different test groups were used in which nucleotomy had been performed during surgeryin vivoand under isolatedin vitroconditions, respectively. In accordance with expectations,in vitronucleotomy on ovine motion segments significantly increased flexibility. By contrast, nucleotomy significantly decreased flexibility 12 weeks after surgery. After removal of the posterior structures, however, the differences in flexibility diminished. The present results thus suggest that it might not exclusively be the trauma to the intervertebral disc during surgery which is decisive for post-operative stability, but rather adaptive mechanisms in the posterior structures. Therefore, care should be taken to minimize the damage to the posterior structures in the course of the surgical approach, which more likely compromises stability.
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1990 年沃尔沃临床科学奖：用于测量腰椎运动节段矢状平移的 X 线图的一致性和准确性：实验模型
影响因子：
3
作者：
W. Shaffer;K. Spratt;J. Weinstein;T. Lehmann;V. Goel
通讯作者：
V. Goel
腰椎不稳定
DOI：
10.1007/978-1-4613-9326-9_16
发表时间：
1992
期刊：
Journal of Spinal Disorders
影响因子：
--
作者：
P. O'leary
通讯作者：
P. O'leary
标准腰椎间盘切除术对节段运动的影响：使用放射立体测量法进行 5 年随访
影响因子：
2.7
作者：
K. Halldin;B. Zoëga;P. Nyberg;Johan Kärrholm;Bengt Lind
通讯作者：
Bengt Lind
[腰椎间盘核摘除术后翻修手术的长期结果]]。
DOI：
--
发表时间：
1996
期刊：
Zeitschrift für Orthopädie und ihre Grenzgebiete
影响因子：
--
作者：
J. Jerosch;W. Castro
通讯作者：
W. Castro
影响因子：
5.3
作者：
Katz, JN
通讯作者：
Katz, JN