Abstract:
STUDY DESIGN:This in vitro biomechanical study examines segmental anterior vertebral screw strain and solid rod construct stiffness with and without the addition of multilevel, threaded cortical bone dowels in a bovine model. OBJECTIVE:To determine whether strain at the bone-screw interface is higher at the end levels during physiologic range loading, and whether solid interspace support decreases segmental strain on the implant. SUMMARY OF BACKGROUND DATA:Anterior instrumentation provides greater correction and preserves distal motion segments. However, nonunion and implant failure are observed more frequently than with posterior segmental instrumentation, and when observed, loss of fixation occurs at the end levels. METHODS:Eight calf spines underwent mechanical testing in the following sequence: 1) intact condition, 2) anterior release with anterior solid rod and bicortical rib grafts, and 3) anterior release with anterior solid rod and threaded cortical bone dowels (L2-L5). Instrumented vertebral screws were used to assess strain within the vertebral body by the near cortex, whereas an anterior extensometer spanning the instrumented segments was used to measure segmental displacements to calculate construct stiffness. The protocol included axial compression (-400 N), right lateral bending (4 Nm (Newton-meter), away from the implant), and left lateral bending (4 Nm, toward the implant). Statistical analysis included a one-way analysis of variance and a Student-Newman-Keuls post hoc test. A pilot study was performed using four additional specimens loaded for 4000 cycles to investigate macroscopic loosening after fatigue loading. RESULTS:In lateral bending toward the implant, the strain was higher at both end levels, with no differences between the rib and dowel reconstructions. The stiffness values were greater than the intact values for both groups. In lateral bending away from the implant, the strain also was higher at both end screws, and the dowel group had less strain at these levels than the rib group. Both groups were stiffer than the intact condition, and the dowel group was stiffer than the rib group. Axial compressive strain also was higher at the end levels, but this difference did not reach statistical significance. The rib group did not reach intact stiffness values, whereas the dowel group was stiffer than the intact condition. The fatigue study showed gross loosening at one or both end levels in all cases. CONCLUSIONS:Higher strain was observed at the bone-screw interface in both end screws of an anterior solid rod construct during lateral bending, which correlates with the clinically observed failure location. This suggests that physiologic range loading may predispose to failure at the end levels. Disc space augmentation with solid implants increased construct stiffness in all three load paths and decreased strain at the end levels in lateral bending away from the implant. Future implant modifications should achieve better fixation at the end screws, and the current model provides a means to compare different strategies to decrease strain at these levels.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Spiegel DA,Cunningham BW,Oda I,Dormans JP,McAfee PC,Drummond DSdoi
10.1097/00007632-200011010-00007keywords:
subject
Has Abstractpub_date
2000-11-01 00:00:00pages
2755-61issue
21eissn
0362-2436issn
1528-1159journal_volume
25pub_type
杂志文章相关文献
SPINE文献大全abstract:STUDY DESIGN:Literature review. OBJECTIVES:To assess the frequency of lumbar fusion procedures in the United States; changes in the incidence of fusion in the past 12 years; variations in fusion procedure rates among geographic regions of the nation and between the United States and other countries; costs of lumbar fu...
journal_title:Spine
pub_type: 杂志文章,评审
doi:
更新日期:1995-12-15 00:00:00
abstract::Anterior stabilization with combined plate and bone fusion was performed after neural decompression on ten patients for spondylotic cervical myelopathy, and for radiculopathy or trauma in three patients. Medial corpectomy was performed at one to four levels. Iliac crest or fibular bone grafts were secured by plates an...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198803000-00003
更新日期:1988-03-01 00:00:00
abstract::In this study, the authors evaluated the stiffness of motion segments in intact spines in two spine fracture models, and with each of five implant systems used for posterior fixation of thoracolumbar spine fractures. The devices represented a cross-section of types, including those employing sublaminar wires with and ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198805000-00003
更新日期:1988-05-01 00:00:00
abstract:STUDY DESIGN:A sheep cervical spine interbody fusion model was used to determine the effect of combined insulin-like growth factor-I (IGF-I) and transforming growth factor-beta-1 (TGF-beta1) applied by a poly-(D,L-lactide) (PDLLA)-coated cage. OBJECTIVES:The purpose of this study was to determine the effect of a new P...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200208150-00006
更新日期:2002-08-15 00:00:00
abstract::Twenty-nine fragments from herniated lumbar discs of patients over 60 years of age were studied pathohistologically. For comparison, 109 discs from patients under 59 years of age also were observed. They were classified into seven types according to their composition. In 70% of discs from patients between 60 and 69 an...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198909000-00017
更新日期:1989-09-01 00:00:00
abstract:STUDY DESIGN:A numerical study was conducted by simulating in situ contouring (ISC) surgery. OBJECTIVE:To quantify intraoperative correction during ISC surgery. SUMMARY OF BACKGROUND DATA:Surgical techniques correcting scoliosis, like the ISC one, lead to a complex 3-dimensional correction of the spine. Using motion ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181b8eaca
更新日期:2010-02-15 00:00:00
abstract:STUDY DESIGN:Retrospective study. OBJECTIVE:To evaluate the incidence of fusion failure after anterior screw fixation of type II and rostral shallow type III fractures and to identify related risk factors. SUMMARY OF BACKGROUND DATA:Although several studies have reported fusion rates after anterior odontoid screw fix...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31820e6418
更新日期:2012-01-01 00:00:00
abstract:STUDY DESIGN:This was a single-institute retrospective study. OBJECTIVE:To describe perioperative and postoperative complications in elderly who underwent multilevel minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) while identifying predictors of complications. SUMMARY OF BACKGROUND DATA:The numbe...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000003369
更新日期:2020-06-01 00:00:00
abstract:STUDY DESIGN:Retrospective case series. OBJECTIVE:Our goal was to assess whether en bloc resection had an impact on survival. SUMMARY OF BACKGROUND DATA:Osteogenic sarcoma occurs rarely in the mobile spine, but when it does, the prognosis is poor. Wide resection is recommended for osteogenic sarcoma of the extremitie...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31822fb1a7
更新日期:2012-03-15 00:00:00
abstract:STUDY DESIGN:Prospective, multicenter, cohort study. OBJECTIVE:To examine which clinical and sociodemographic baseline variables can predict a favorable outcome in subjects with neck pain treated by chiropractors. SUMMARY OF BACKGROUND DATA:Relatively little is known on predictors of neck pain, particularly for those...
journal_title:Spine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/BRS.0b013e3181753cc9
更新日期:2008-06-01 00:00:00
abstract:STUDY DESIGN:Scoliosis patients were prospectively x-rayed in three positions with independent analysis. OBJECTIVES:To determine if one positioning technique provides superior visualization of critical landmarks (C7, T2, T12, L5-S1) and to determine any position dependent variations in regional measures or sagittal ba...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000153698.94091.f8
更新日期:2005-02-15 00:00:00
abstract:STUDY DESIGN:A 12-year prospective study of pre-existing and de novo degenerative lumbar scoliosis (DLS) among community-based female volunteers. OBJECTIVE:To investigate serial entire spine radiographs of healthy female volunteers and to clarify radiographical characteristics and predictors of pre-existing and de nov...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3182575eaa
更新日期:2012-09-15 00:00:00
abstract:STUDY DESIGN:Prospective validity study. OBJECTIVE:To determine how accurately intermittent fluoroscopy detects inadvertent intravascular injection during transforaminal epidurals. SUMMARY OF BACKGROUND DATA:Serious morbidity caused by transforaminal epidural injections is frequently related to inadvertent vascular i...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31816960fe
更新日期:2008-04-01 00:00:00
abstract:STUDY DESIGN:Report of the use of one segmental artery from the left renal artery as inflow source for reconstructing a spine with recalcitrant osteomyelitis. OBJECTIVE:To describe one difficult case of spinal osteomyelitis and our reconstruction procedure. SUMMARY OF BACKGROUND DATA:The use of a vascularized fibular...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181ecbfa1
更新日期:2010-12-01 00:00:00
abstract:STUDY DESIGN:Systematic literature review. OBJECTIVE:To categorize published evidence systematically for lumbar fusion for chronic low back pain (LBP) in order to provide an updated and comprehensive analysis of the clinical outcomes. SUMMARY OF BACKGROUND DATA:Despite a large number of publications of outcomes of sp...
journal_title:Spine
pub_type: 杂志文章,评审
doi:10.1097/BRS.0b013e3182877f11
更新日期:2013-04-01 00:00:00
abstract:STUDY DESIGN:In this study, data are presented that provide the surgeon with additional information about the internal structure of the thoracic pedicle, which is especially useful for pedicle screw fixation in the thoracic spine. OBJECTIVES:To quantify the internal structure of the pedicle in the thoracic spine. SUM...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199602010-00002
更新日期:1996-02-01 00:00:00
abstract:STUDY DESIGN:Prospective follow-up study. OBJECTIVE:Evaluation of the diagnostic assessment and clinical significance of the intravertebral cleft in painful, long-standing osteoporotic vertebral compression fractures (OVCFs) treated with percutaneous vertebroplasty (PVP). SUMMARY OF BACKGROUND DATA:Patients with pain...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e318238bf22
更新日期:2012-05-15 00:00:00
abstract::Seventeen patients were identified with concomitant thoracolumbar and sacral fractures representing 26% of sacral fractures and 7.7% of pelvic fractures. The thirteen men and four women exhibited a bimodal age distribution. There were thirteen vertical compression thoracolumbar fractures, three transverse process frac...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199308000-00007
更新日期:1993-08-01 00:00:00
abstract:STUDY DESIGN:This study demonstrated the therapeutic value of chemonucleolysis with chondroitinase ABC to canine intervertebral disc displacement. OBJECTIVES:To determine the efficacy of Chondroitinase ABC in the management of canine intervertebral disc displacement. SUMMARY OF BACKGROUND DATA:No previous study has a...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199707010-00002
更新日期:1997-07-01 00:00:00
abstract:STUDY DESIGN:Retrospective case series. OBJECTIVE:To report the effect of repeated growing rod (GR) lengthenings on the sagittal and pelvic profile in patients with early-onset scoliosis. SUMMARY OF BACKGROUND DATA:Posterior distraction-based GRs have gained popularity as a technique for the surgical management of ea...
journal_title:Spine
pub_type: 杂志文章,多中心研究
doi:10.1097/BRS.0000000000000565
更新日期:2014-10-15 00:00:00
abstract:STUDY DESIGN:Analysis of segmental and total lumbar range of motion (ROM) before and after total lumbar disc replacement. OBJECTIVE:To examine the relationship between absolute segmental and total lumbar ROM and evolution of ROM on clinical outcome. SUMMARY OF BACKGROUND DATA:At the moment, data are scarce with regar...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31819b213c
更新日期:2009-04-20 00:00:00
abstract:STUDY DESIGN:A propensity score matching study. OBJECTIVE:The aim of this study was to assess the cost-effectiveness of balloon kyphoplasty (BKP) in Japan. SUMMARY OF BACKGROUND DATA:Osteoporotic vertebral fracture (OVF) is a common disease in elderly people. In Japan, the incidence of painful OVF in 2008 was estimat...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002829
更新日期:2019-03-01 00:00:00
abstract:STUDY DESIGN:This study was an exploratory repeated measures design comparing patients undergoing two magnitudes of surgery in the lumbar spine: lumbar herniated disc repair and posterior lumbar fusion. OBJECTIVE:The present study evaluated and compared the effect of perceived pain, perceived stress, anxiety, and mood...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000231795.85409.87
更新日期:2006-08-15 00:00:00
abstract::Biomechanical models of the spine have traditionally assumed that workplace lifting conditions (weight, posture, motion, etc.) precisely dictate the magnitude of individual muscle forces necessary to maintain a biomechanical balance within the trunk. However, because there are a large number of muscle groups within th...
journal_title:Spine
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract:STUDY DESIGN:As-treated analysis of the Spine Patient Outcomes Research Trial. OBJECTIVE:To compare baseline characteristics and surgical and nonoperative outcomes in degenerative spondylolisthesis (DS) and spinal stenosis (SpS) patients stratified by predominant pain location (i.e., leg vs. back). SUMMARY OF BACKGRO...
journal_title:Spine
pub_type: 杂志文章,随机对照试验
doi:10.1097/BRS.0b013e3181d77c21
更新日期:2011-02-01 00:00:00
abstract:STUDY DESIGN:Asymptomatic volunteers underwent magnetic resonance imaging to investigate how different positions affect lumbar intervertebral discs. OBJECTIVE:To quantify sagittal migration of the lumbar nucleus pulposus in 6 functional positions. SUMMARY OF BACKGROUND DATA:Previous studies of the intervertebral disc...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e318067dccb
更新日期:2007-06-15 00:00:00
abstract:STUDY DESIGN:Retrospective cohort study. OBJECTIVE:To identify factors associated with blood transfusion for primary posterior lumbar fusion surgery, and to identify associations between blood transfusion and other postoperative complications. SUMMARY OF BACKGROUND DATA:Blood transfusion is a relatively common occurr...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001047
更新日期:2015-11-01 00:00:00
abstract:STUDY DESIGN:This is a prospective, randomized study comparing iliac crest bone graft to bone morphogenetic protein (BMP)/compression resistant matrix in instrumented posterolateral fusions for single-level lumbar degenerative disease. A higher recombinant human bone morphogenetic protein (rhBMP)-2 dose and a carrier s...
journal_title:Spine
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.brs.0000240715.78657.81
更新日期:2006-10-15 00:00:00
abstract:STUDY DESIGN:Experimental measurement of bovine caudal annulus fibrosus (AF) biaxial stress-strain states for unloaded motion segments and those loaded in flexion combined with axial compression. OBJECTIVE:To measure AF biaxial stress-strain states for motion segments free of external loads and those loaded in flexion...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e318259aa60
更新日期:2012-08-15 00:00:00
abstract:STUDY DESIGN:Investigation on architecture of lumbar pedicle. OBJECTIVE:To determine morphological properties of pedicular cancellous bone. SUMMARY OF BACKGROUND DATA:Many researchers have been stimulated to study trabecular architecture by improvements in stereological technology. Although the structure of vertebral...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000168373.24644.9f
更新日期:2005-07-01 00:00:00