首页> 美国卫生研究院文献>Springer Open Choice >Reduction of intradiscal pressure by the use of polycarbonate-urethane rods as compared to titanium rods in posterior thoracolumbar spinal fixation
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Reduction of intradiscal pressure by the use of polycarbonate-urethane rods as compared to titanium rods in posterior thoracolumbar spinal fixation

机译:与在胸腰椎后路脊柱固定中的钛棒相比通过使用聚碳酸酯-氨基甲酸乙酯棒降低椎间盘内压力

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摘要

AbstractLoss of sagittal alignment and balance in adult spinal deformity can cause severe pain, disability and progressive neurological deficit. When conservative treatment has failed, spinal fusion using rigid instrumentation is currently the salvage treatment to stop further curve progression. However, fusion surgery is associated with high revision rates due to instrumentation failure and proximal junctional failure, especially if patients also suffer from osteoporosis. To address these drawbacks, a less rigid rod construct is proposed, which is hypothesized to provide a more gradual transition of force and load distribution over spinal segments in comparison to stiff titanium rods. In this study, the effect of variation in rod stiffness on the intradiscal pressure (IDP) of fixed spinal segments during flexion-compression loading was assessed. An ex vivo multisegment (porcine) flexion-compression spine test comparing rigid titanium rods with more flexible polycarbonate-urethane (PCU) rods was used. An increase in peak IDP was found for both the titanium and PCU instrumentation groups as compared to the uninstrumented controls. The peak IDP for the spines instrumented with the PCU rods was significantly lower in comparison to the titanium instrumentation group. These results demonstrated the differences in mechanical load transfer characteristics between PCU and titanium rod constructs when subjected to flexion-compression loading. The concept of stabilization with a less rigid rod may be an alternative to fusion with rigid instrumentation, with the aim of decreasing mechanical stress on the instrumented segments and the possible benefit of a decrease in the incidence of screw pullout.
机译:摘要成人脊柱畸形的矢状位对准和平衡丢失会引起严重的疼痛,残疾和进行性神经功能缺损。当保守治疗失败时,使用刚性器械的脊柱融合术目前是挽救治疗以阻止进一步弯曲发展的方法。然而,由于器械失败和近端连接失败,融合手术与高翻修率相关,尤其是如果患者也患有骨质疏松症。为了解决这些缺点,提出了一种刚性较小的杆构造,与刚性的钛杆相比,假设该杆构造可在脊柱节段上提供更渐进的力和载荷分布过渡。在这项研究中,评估了屈曲压缩负荷过程中杆刚度变化对固定脊柱节段内压力(IDP)的影响。使用离体多段(猪)弯曲-压缩脊柱测试,将刚性钛棒与更具柔性的聚碳酸酯-聚氨酯(PCU)棒进行比较。与未使用仪器的对照组相比,钛和PCU仪器组的IDP峰值均增加。与钛仪器组相比,装有PCU棒的刺的IDP峰值明显更低。这些结果证明了当受到弯曲压缩载荷时,PCU和钛棒结构之间的机械载荷传递特性有所不同。用较少刚性的杆来稳定的概念可以替代与刚性仪器融合的目的,目的是减少对仪器段的机械应力,并可能减少螺钉拔出的发生。

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