In vitro biomechanical analysis of three anterior thoracolumbar implants
In vitro biomechanical analysis of three anterior thoracolumbar implants
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DOI：
10.3171/spi.2000.93.2.0252
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发表时间：
2000-10-01
影响因子：
4.1
通讯作者：
Totoribe, K
中科院分区：
文献类型：
--
作者：
Hitchon, PW;Goel, VK;Totoribe, K
Object.本研究的目的是评价三种常用的胸腰椎前路植入物的比较有效性：胸腰椎前路锁定钢板（ATLP）、光滑棒Kaneda（SRK）和Z型钢板。使用人尸体脊柱的T9-L3节段进行体外静息。进行了L-l椎体次全切除术，并使用三种前路器械中的一种实现了稳定：ATLP用于9例脊柱，SRK用于10例，Z型钢板用于10例。在屈曲和伸展、右侧和左侧弯曲以及右侧和左侧轴向旋转时，对样本进行1.5、3、4.5和6 Nm载荷测试。使用两台摄像机跟踪连接在椎体上的发光二极管来监测角运动。在器械在+/- 3 Nm下疲劳至5000次循环后和双侧关节突切除术后，在完整状态下对使用上述三种器械之一稳定的脊柱进行测试。使用三种器械时，完整脊柱的稳定性没有差异，SRK和Z钢板内固定脊柱在任何状态下都没有差异。在伸展测试中，使用SRK（4.7 +/- 3.2度）和Z钢板器械（3.3 +/- 2.3度）的脊柱的平均角旋转（+/-标准差）比在ATL P稳定脊柱中观察到的（9 +/- 4.8度）更刚性。然而，在疲劳诱导后的屈曲测试中，只有SRK（4.2 +/- 3.2度）比ATLP（8.9 +/- 4.9度）更硬。此外，在疲劳后伸展中，只有SRK（2.4 +/- 3.4度）比ATLP（6.4 +/- 2.9度）提供更坚固的固定。所有三种器械在双侧关节面切除术后均同样不稳定。SRK和Z-plate胸腰椎前路植入物的刚度均高于ATLP，且SRK的刚度高于ATLP。作者的研究结果表明，在外形和易于应用不是最重要的情况下，SRK在术后立即实现刚性固定方面优于其他两种受试植入物。
Object. The goal of this study was to evaluate the comparative efficacy of three commonly used anterior thoracolumbar implants: the anterior thoracolumbar locking plate (ATLP), the smooth-rod Kaneda (SRK), and the Z-plate.Methods. in vitro resting was performed using the T9-L3 segments of human cadaver spines. An L-l corpectomy was per formed, and stabilization was achieved using one of three anterior devices: the ATLP in nine spines, the SRK in 10, and the Z-plate in 10. Specimens were load tested with 1.5-, 3-, 4.5-, and 6-Nm in flexion and extension, right and left lateral bending, and right and left axial rotation. Angular motion was monitored using two video cameras that tracked light-emitting diodes attached to the vertebral bodies. Testing was performed in the intact state in spines stabilized with one of the three aforementioned devices after the devices had been fatigued to 5000 cycles at +/- 3 Nm and after bilateral facetectomy. There was no difference in the stability of the intact spines with use of the three devices.There were no differences between the SRK- and Z-plate-instrumented spines in any state. In extension testing, the mean angular rotation (+/- standard deviation) of spines instrumented with the SRK (4.7 +/- 3.2 degrees) and Z-plate devices (3.3 +/- 2.3 degrees) was more rigid than that observed in the ATLP-stabilized spines (9 +/- 4.8 degrees). In flexion testing after induction of fatigue, however, only the SRK (4.2 +/- 3.2 degrees) was stiffer than the ATLP (8.9 +/- 4.9 degrees). Also, in extension postfatigue, only the SRK (2.4 +/- 3.4 degrees) provided more rigid fixation than the ATLP (6.4 +/- 2.9 degrees). All three devices were equally unstable after bilateral facetectomy. The SRK and Z-plate anterior thoracolumbar implants were both more rigid than the ATLP, and of the former two the SRK was stiffer.Conclusions. The authors' results suggest that in cases in which profile and ease of application are not of paramount importance, the SRK has an advantage over the other two tested implants in achieving rigid fixation immediately postoperatively.