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首页> 外文期刊>Journal of Neurosurgery. Spine. >Biomechanical study on the effect of five different lumbar reconstruction techniques on adjacent-level intradiscal pressure and lamina strain.
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Biomechanical study on the effect of five different lumbar reconstruction techniques on adjacent-level intradiscal pressure and lamina strain.

机译：五种不同的腰椎重建技术对邻近水平的椎间盘内压和椎板张力的影响的生物力学研究。

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OBJECT: The objectives of this study were to compare the biomechanical effects of five lumbar reconstruction models on the adjacent segment and to analyze the effects of three factors: construct stiffness, sagittal alignment, and the number of fused segments. METHODS: Nondestructive flexion-extension tests were performed by applying pure moments to 10 calf spinal (L3-S1) specimens. One-segment (L5-6) or two-segment (L5-S1) posterior fusion methods were simulated: 1) one-segment posterolateral fusion (PLF); 2) one-segment PLF with interbody fusion cages (one-segment PLIF/PLF); 3) two-segment PLF; 4) two-segment PLIF/PLF; and 5) two-segment PLF in kyphosis (two-segment kyphotic PLF). The range of motion (ROM) of the reconstructed segments, intradiscal pressure (IDP), and lamina strain in the upper (L4-5) adjacent segment were analyzed. The ROM was significantly decreased in the PLIF/PLF models compared with that in the PLF alone models after both the one- and two-segment fusions. If the number of fused segments was increased, the pressure and strains were also increased in specimens subjected to the PLIF/PLF procedure, more so than the PLF-alone procedure. In the one-segment PLIF/PLF model the authors observed a reduced IDP and lamina strain compared with those in the kyphotic two-segment PLF model despite the latter's higher levels of initial stiffness. CONCLUSIONS: If the number of fused levels can be reduced by using PLIF to correct local kyphosis, then this procedure may be valuable for reducing adjacent-segment degenerative changes.
机译：目的：本研究的目的是比较五个腰椎重建模型对相邻节段的生物力学影响，并分析三个因素的影响：构造刚度，矢状位和融合节段数。方法：通过对10个小腿脊柱（L3-S1）标本施加纯力矩来进行无损屈伸测试。模拟了单节（L5-6）或两节（L5-S1）后路融合方法：1）单节后外侧融合（PLF）; 2）带椎间融合器的单段PLF（单段PLIF / PLF）; 3）两段式PLF; 4）两段式PLIF / PLF;和5）后凸畸形的两段式PLF（两段式后凸PLF）。分析了重建节段的运动范围（ROM），椎间盘内压力（IDP）和上部（L4-5）相邻节段的椎板应变。在单段和两段融合之后，PLIF / PLF模型的ROM与单独PLF模型的ROM相比显着降低。如果增加了熔融段的数量，则经受PLIF / PLF程序的样品中的压力和应变也会增加，这比单独使用PLF的程序更多。在单段PLIF / PLF模型中，与后凸两段PLF模型相比，作者观察到IDP和椎板应变降低，尽管后者的初始刚度较高。结论：如果可以通过使用PLIF矫正局部后凸畸形来减少融合水平的数量，那么该程序对于减少邻近节段的退行性改变可能是有价值的。

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