Investigation of the mechanical regulation of lumbar inter-corporeal spinal fusion

腰椎椎体间融合的力学调节研究

• 批准号: 322722460
• 负责人: Professor Dr. Hendrik Schmidt
• 金额: --
• 依托单位: Julius Wolff Institut für Biomechanik und Muskuloskeletale Regeneration (CVK)
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2016
• 资助国家: 德国
• 起止时间: 2015-12-31 至 2020-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/322722460?language=en
• 关键词: Investigation; mechanical; regulation; lumbar; inter

The degeneration of the intervertebral disc is one of the most common causes of specific lower back pain. Due to multiple reasons, degeneration can lead to segmental instability. Anterior inter-corporeal spinal fusion is currently the most effective surgical treatment to correct segmental instability. In most cases, a spinal cage in combination with autogenous cancellous bone is used to achieve a permanent bony fusion of one or more vertebral segments. One of the most common complications of spinal fusion is nonunion, often due to mechanical (e.g., instabilities, overloading, stress shielding) and biological (e.g., restricted vascularization) reasons. Thereby, the insertion of a rigid implant causes a reduction in the mechanical stimulus required for bone formation in the fusion region. This can result in early implant failure, loss of stability or malposition of the implant and pain; associated with considerable health risks and the necessity for re-operation.The process of bone formation during inter-corporeal spinal fusion is poorly understood. Therefore, the main goal of this research project is to investigate the mechanical regulation of lumbar spinal fusion following spondylodesis. For this purpose, finite element models of lumbar motion segments will be developed, that incorporate the mechanical and biological factors influencing the fusion process. This knowledge will allow us to identify factors contributing to delayed healing or nonunions in some patients. In addition, cages will be optimized for the lumbar spine, which will significantly enhance skeletal fixation and reduce the time required for complete bony fusion compared to clinically available implants. This should reduce the risk of non-unions and revision surgeries as well as the associated health care costs.

椎间盘的退变是特定下背痛的最常见原因之一。由于多种原因，退变可导致节段性不稳定。前路椎体间融合术是目前矫正节段性不稳定最有效的手术方法。在大多数情况下，脊柱融合器结合自体松质骨用于实现一个或多个椎体节段的永久性骨性融合。脊柱融合术最常见的并发症之一是骨不连，通常是由于机械（例如，不稳定性、过载、应力屏蔽）和生物学（例如，限制血管形成）的原因。因此，刚性植入物的插入导致融合区域中骨形成所需的机械刺激减少。这可能导致植入物早期失效、失去稳定性或植入物错位和疼痛;与相当大的健康风险和再次手术的必要性相关。因此，本研究的主要目的是探讨脊柱融合术后腰椎融合的力学调节。为此，将开发腰椎活动节段的有限元模型，该模型将影响融合过程的机械和生物学因素结合起来。这些知识将使我们能够确定导致某些患者延迟愈合或骨不连的因素。此外，融合器将针对腰椎进行优化，与临床可用植入物相比，这将显著增强骨骼固定并缩短完全骨融合所需的时间。这将降低骨不连和翻修手术的风险以及相关的医疗费用。

项目成果

Review article on spine kinematics of quadrupeds and bipeds during walking.

• DOI: 10.1016/j.jbiomech.2020.109631
• 发表时间: 2020-01
• 期刊: Journal of biomechanics
• 影响因子: 2.4
• 作者: Sandra Reitmaier;H. Schmidt