OPTIMIZING FIXATION TECHNIQUES FOR BURST FRACTURES

描述：(改编自调查人员摘要)骨折 脊柱的胸腰椎区域是严重的致残性损伤，导致 个人痛苦和对社会的重大损失。短片段 固定装置(椎弓根螺钉和前路器械)在 使用，并具有仅固定最低限度所需的优点 脊椎节段的数量。这些设备有两个方面 临床重要：椎管和椎间孔缩小 侵袭和稳定骨折的脊柱。强者的力量 已经对脊柱装置进行了研究。然而，他们稳定经济的能力 多个生理方向的脊柱经常被省略在 实验研究。设备故障并不少见，但故障可能 与其说与设备的强度有关，不如说与其稳定的能力有关。 骨折部位的稳定性是必要的，以增加早期 聚变，从而卸载设备并防止其故障。确实有 没有生物力学研究，使用的是真实的胸腰椎爆裂性骨折 模型，研究了短节段固定的调整 同时优化椎管和椎间孔的装置 以及设备提供的多方向稳定性。 新鲜的胸腰椎标本将受到高速处理 会导致临床相关的爆裂性骨折的创伤。利用一种 独特的增量创伤方法，申请者将产生爆发式 不同严重程度的骨折。使用创新模式研究 通用短节段装置.椎管缩小的一般标准 以及椎间孔间侵袭将被确立。其他内容 实验将使用特定的前后路装置进行 以确定其最佳使用的临床相关指南。vt.在.上 在比较的基础上，申请者将研究修复 不同严重程度爆裂性骨折的多向稳定性 单独或联合应用前后路装置。 椎弓根固定装置越来越受欢迎，但也存在担忧 来自政府机构和矫形外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研究。生物力学研究 可以提供客观的数据来帮助解决这些争议。这个 被提名的申请者建议，这项研究最优化的一项 脊柱固定常用的外科手术。他们觉得 调查结果将为外科医生和治疗提供客观的指导 给病人带来的好处。临床相关性是本研究的主要目的。 研究，它可能有助于在医疗保健成本控制的水平 治疗。

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.