Influence of the sagittal balance on the segmental load and the success of the surgical treatment of degenerative diseases of the spine

矢状面平衡对节段负荷的影响及脊柱退行性疾病手术治疗成功的影响

• 批准号: 237066896
• 负责人: Professor Dr. Michael Putzier
• 金额: --
• 依托单位: Klinik für Orthopädie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2013
• 资助国家: 德国
• 起止时间: 2012-12-31 至 2015-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/237066896?language=en
• 关键词: Influence; sagittal; balance; segmental; load

Until now it has only been assumed that the sagittal profile of the spine is a predisposing factor for the development of different degeneration patterns at the lumbar spine due to the different biomechanical loads. Besides this, the sagittal balance of the spine possibly plays a significant role for the success of surgical treatment methods. Both assumptions have not yet been evaluated, neither in biomechanical models nor in clinical or radiological studies. Within the framework of the project, the muscle forces are estimated using an inverse-dynamic model and transferred to finite element models of the lumbar spine with different sagittal profiles. Within the models, degeneration relevant biomechanical differences can be validated and different single-level surgical treatment options will be simulated. Parallel to this, a patient cohort will be analyzed for profile specific degeneration patterns. In another group of patients the influence of pre- and postoperative parameters of the sagittal balance on the clinical and radiological results of the surgical treatment will be investigated. The recombination of the model-based and the clinical and radiological results allows the optimization of the computer models itselves and the determination of prognostic and preventive factors for the preservation of the spinal balance. Furthermore, it will be possible to increase the success rate of necessary surgical interventions by implementation of the findings of this project in the clinical practice.

到目前为止，人们只认为脊柱的矢状面是腰椎由于不同的生物力学负荷而形成不同退变模式的诱因。此外，脊柱的矢状面平衡可能对手术治疗的成功起着重要作用。无论是在生物力学模型中，还是在临床或放射学研究中，这两种假设都尚未得到评估。在该项目的框架内，使用反向动力学模型估计肌力，并将其转移到具有不同矢状面轮廓的腰椎的有限元模型。在这些模型中，可以验证退变相关的生物力学差异，并将模拟不同的单节段手术治疗方案。与此平行的是，将对患者队列进行分析，以确定特定的退行性改变模式。在另一组患者中，将调查前后矢状面平衡参数对手术治疗的临床和放射学结果的影响。基于模型的结果与临床和放射学结果的重新组合允许计算机模型本身的优化，并确定用于保持脊柱平衡的预后和预防因素。此外，通过将该项目的结果应用于临床实践，将有可能提高必要的外科干预的成功率。

项目成果

In vivo implant forces acting on a vertebral body replacement during upper body flexion.

上身屈曲期间作用于椎体置换物的体内植入力

• DOI: 10.1016/j.jbiomech.2015.01.007
• 发表时间: 2015
• 期刊: Journal of biomechanics
• 影响因子: 2.4
• 作者: Marcel Dreischarf;Laia Albiol;Thomas Zander;Rizwan Arshad;Friedmar Graichen;Georg Bergmann;Hendrik Schmidt;Antonius Rohlmann
• 通讯作者: Antonius Rohlmann

Differences between clinical "snap-shot" and "real-life" assessments of lumbar spine alignment and motion - What is the "real" lumbar lordosis of a human being?

• DOI: 10.1016/j.jbiomech.2016.01.032
• 发表时间: 2016-03-21
• 期刊: JOURNAL OF BIOMECHANICS
• 影响因子: 2.4
• 作者: Dreischarf, Marcel;Pries, Esther;Schmidt, Hendrik
• 通讯作者: Schmidt, Hendrik