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首页> 外文期刊>Spine >Posterior lumbar interbody fusion. A biomechanical comparison, including a new threaded cage.
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Posterior lumbar interbody fusion. A biomechanical comparison, including a new threaded cage.

机译：腰椎后椎体融合。生物力学比较，包括新的螺纹笼。

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STUDY DESIGN: In vitro biomechanical testing was performed on eight lumbar calf spines. OBJECTIVES: To compare the initial stiffness of a standard method of posterior lumbar interbody fusion using structural autograft with the same procedure using additional posterior instrumentation. These constructs also were compared to a new titanium implant. SUMMARY OF BACKGROUND DATA: Posterior lumbar interbody fusion is gaining wide acceptance for the treatment of segmental spinal instability, spondylolisthesis, and discogenic pain. Many methods have been described, including use of autograft or allograft bone, in either structural or nonstructural form, with or without additional fixation. A new threaded titanium interbody implant has been designed to increase initial stability while allowing bony ingrowth for fusion. METHODS: Eight lumbar calf spines were subjected to axial compression, sagittal moments (flexion-extension), and axial torque while displacement was measured. Stiffness was calculated from the load displacement curves for each construct under each load pattern. RESULTS: The posterior lumbar interbody fusion by bone graft alone was the least stiff construct of all modes tested. In two of eight specimens the bone graft dislodged posteriorly into the canal during torsional testing. The titanium interbody implant was similar in stiffness to the bone graft posterior lumbar interbody fusion with posterior instrumentation group in all three modes. They were both significantly stiffer than the normal spine, the destabilized spine, and the posterior lumbar interbody fusion by bone graft alone (P < 0.05). CONCLUSIONS: In this model, the posterior lumbar interbody fusion with bone graft alone had less initial stiffness than that of the intact spine. The addition of posterior instrumentation or interbody implants can increase initial stiffness significantly.
机译：研究设计：体外生物力学测试是在八个腰小腿棘上进行的。目的：比较采用结构性自体植骨的腰椎后路椎体间融合标准方法的初始刚度，以及采用相同的手术方法和额外的后路器械。这些构造也与新的钛植入物进行了比较。背景数据摘要：后路腰椎椎间融合治疗在节段性脊柱不稳，脊椎滑脱和椎间盘源性疼痛的治疗方面获得了广泛的接受。已经描述了许多方法，包括使用结构或非结构形式的自体移植或同种异体移植骨，带有或不带有附加固定装置。一种新的带螺纹的钛椎间植入物已被设计为增加初始稳定性，同时允许骨向内生长以进行融合。方法：在测量位移的同时，对八只腰小腿脊柱进行轴向压缩，矢状矩（屈伸）和轴向扭矩。从每种载荷模式下每种结构的载荷位移曲线计算刚度。结果：仅通过骨移植进行后腰椎椎体间融合术是所有测试模式中刚度最小的构造。在八个样本中，有两个样本在扭转测试中将骨移植物向后移入了管内。在所有这三种模式下，钛椎体间植入物的刚度都类似于骨后路椎体间融合与后置器械组的刚度。它们都比正常脊柱，不稳定的脊柱和仅通过植骨进行的腰椎后椎体融合强得多（P <0.05）。结论：在该模型中，仅后路腰椎椎间融合与单独植骨相比，其初始刚度要小于完整脊柱。后置器械或椎体间植入物的添加可以显着提高初始刚度。

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