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首页> 外文期刊>Spine >Comparison of biomechanical function at ideal and varied surgical placement for two lumbar artificial disc implant designs: mobile-core versus fixed-core.
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Comparison of biomechanical function at ideal and varied surgical placement for two lumbar artificial disc implant designs: mobile-core versus fixed-core.

机译：比较两种腰椎人工椎间盘植入物设计在理想和不同手术位置下的生物力学功能：可动芯与固定芯。

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STUDY DESIGN: Finite element model. OBJECTIVES: To estimate the effect of lumbar mobile-core and fixed-core artificial disc design and placement on the loading of the facet joints, and stresses on the polyethylene core. SUMMARY OF BACKGROUND DATA: Although both mobile-core and fixed-core lumbar artificial disc designs have been used clinically, the effect of their design and the effect of placement within the disc space on the structural element loading, and in particular the facets and the implant itself, have not been investigated. METHODS: A 3D nonlinear finite element model of an intact ligamentous L4-L5 motion segment was developed and validated in all 6 df based on previous experiments conducted on human cadavers. Facet loading of a mobile-core TDR and a fixed-core TDR were estimated with 4 different prosthesis placements for 3 different ranges of motion. RESULTS: Placing the mobile-core TDR anywhere within the disc space reduced facet loading by more than 50%, while the fixed-core TDR increased facet loading by more than 10% when compared with the intact disc in axial rotation. For central (ideal) placement, the mobile- and fixed-core implants were subjected to compressive stresses on the order of 3 MPa and 24 MPa, respectively. The mobile-core stresses were not affected by implant placement, while the fixed-core stresses increased by up to 40%. CONCLUSION: A mobile-core artificial disc design is less sensitive to placement, and unloads the facet joints, compared with a fixed-core design. The decreased core stress may result in a reduced potential for wear in a mobile-core prosthesis compared with a fixed-core prosthesis, which may increase the functional longevity of the device.
机译：研究设计：有限元模型。目的：评估腰椎活动核和固定核人工椎间盘的设计和放置对小关节负荷和聚乙烯核应力的影响。背景数据概述：尽管临床上已经使用了可移动核心和固定核心的腰椎人工椎间盘设计，但是它们的设计以及椎间盘空间内的放置对结构元件载荷，尤其是小平面和椎间盘的影响植入物本身，尚未进行调查。方法：基于先前在人体尸体上进行的实验，开发了完整韧带L4-L5运动段的3D非线性有限元模型，并在所有6 df中对其进行了验证。在3种不同的运动范围内，使用4种不同的假体放置位置估计了移动核心TDR和固定核心TDR的刻面负荷。结果：将移动核心TDR放置在磁盘空间内的任何位置，可使切面载荷减少50％以上，而固定核心TDR与完整磁盘在轴向旋转时相比，将切面载荷增加10％以上。对于中心（理想）放置，可移动和固定芯植入物分别承受3 MPa和24 MPa量级的压缩应力。移动芯应力不受植入物放置的影响，而固定芯应力最多增加40％。结论：与固定芯设计相比，移动芯人工椎间盘设计对放置的敏感性较低，并且可以卸载小关节。与固定芯假体相比，减小的芯应力可导致移动芯假体的磨损可能性降低，这可增加装置的功能寿命。

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