OPTIMIZING FIXATION TECHNIQUES FOR BURST FRACTURES

优化爆裂骨折的固定技术

• 批准号: 2712436
• 负责人: MANOHAR M PANJABI
• 金额: $ 28.14万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-12-01 至 2000-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2712436
• 关键词: biomechanics; biomedical equipment; bone fracture; cinematography; clinical research; fracture fixation; human therapy evaluation; human tissue; physical model; radiography; spine injury; trauma; vertebrae

DESCRIPTION: (Adapted from investigator's abstract) Fractures of the thoracolumbar region of the spine are serious disabling injuries, resulting in personal suffering and significant loss to society. Short segment fixations (pedicle screw and anterior devices) are increasing rapidly in use, and have the advantage of immobilizing only the minimum necessary number of spinal segments. There are two aspects of these devices that are clinically important: reduction of spinal canal and intervertebral foramen encroachments and stabilization of the fractured spine. The strength of the spinal devices has been studied. However, their capability to stabilize the spine in multiple physiological directions is often left out from experimental studies. Device failures are not uncommon, but the failure may be less related to the device strength than to its ability to stabilize. Stability of the fracture site is necessary to enhance the chances of early fusion, thus unloading the device and prevention of its failure. There are no biomechanical studies, using a realistic thoracolumbar burst fracture model, that have studied the adjustments of the short segment fixation devices to both optimize the spinal canal and intervertebral foramen encroachments, and the multidirectional stability provided by the devices. Fresh thoracolumbar human spine specimens will be subjected to high speed trauma that will result in clinically relevant burst fractures. Utilizing a unique incremental trauma approach, the applicants will produce burst fractures of varying severities. Using an innovative model to study a generic short segment device, general criteria for reducing the spinal canal and intervertebral foramen encroachment will be established. Additional experiments will be conducted with specific anterior and posterior devices to determine clinically relevant guidelines for their optimal use. On a comparative basis, the applicants will study the restoration of multidirectional stability of burst fractures of varying severities by the application of anterior and posterior devices, alone and when combined. Pedicle fixation devices are increasing in popularity, but there is concern from government agencies and controversy among orthopaedic and neurosurgical spine surgeons regarding their efficacy and safety. Biomechanical studies can provide objective data to help resolve these controversies. The proposed applicants suggest that the studies optimize one of the most frequently used surgical procedures for spinal fixation. They feel that the findings will result in objective guidelines for the surgeon and treatment benefits for the patient. Clinical relevance is the primary aim of the study, and it may help in the health care cost containment at the level of treatment.

描述：（改编自研究者摘要） 脊柱的胸腰椎区域是严重的致残性损伤， 个人痛苦和社会重大损失。 短段 固定（椎弓根螺钉和前路器械）在以下地区迅速增加： 使用，并具有仅固定最小必要量的优点 脊柱节段的数量。 这些设备有两个方面， 临床重要：椎管和椎间孔复位 骨折脊柱的侵蚀和稳定。 的强度 已经研究了脊柱装置。 然而，他们稳定 多个生理方向的脊柱通常被排除在外， 实验研究 设备故障并不罕见，但故障可能 与其说与器械强度相关，不如说与器械稳定能力相关。 骨折部位的稳定性是必要的，以提高早期骨折的机会。 熔化，从而卸载装置并防止其失效。 有 无生物力学研究，使用真实的胸腰椎爆裂性骨折 模型，研究了短节段固定的调整 优化椎管和椎间孔的器械 侵入，以及由设备提供的多方向稳定性。 新鲜的胸腰椎人体脊柱标本将受到高速 会导致临床相关爆裂性骨折的创伤。 利用 独特的增量创伤处理方法，会产生申请者的爆发力 不同程度的骨折 利用创新的模型研究 通用短节段装置，减少椎管的一般标准 并且将建立椎间孔侵入。 额外 将使用特定的前后装置进行实验 以确定其最佳使用的临床相关指南。 上 在比较的基础上，申请人将研究恢复 不同严重程度的爆裂性骨折的多向稳定性， 前后路器械的单独应用和联合应用。 椎弓根固定装置越来越受欢迎，但也存在问题， 来自政府机构和骨科和神经外科之间的争议 脊柱外科医生对其有效性和安全性的评价。 生物力学研究 可以提供客观的数据来帮助解决这些争议。 的 建议的申请人建议，这些研究优化了一个最 经常用于脊柱固定的外科手术。 他们觉得 研究结果将为外科医生和治疗提供客观的指导， 对病人的好处。 临床相关性是 研究，它可能有助于在医疗保健成本控制的水平， 治疗