Abstract:
STUDY DESIGN:Cylindrical cages and pedicle screw fixation (PSF) have been used for the setting of a lumbar interbody fusion. OBJECTIVE:To investigate the effects of PSF-nut loosening on lumbar interbody fusion based on the elasto-plateau plasticity of bone characteristics. SUMMARY OF BACKGROUND DATA:The stress-strain curves of bone materials beneath the cages show linear elastic behavior before yielding and then seem to be plateau plastic deformation with further compression strain until opposing cell walls contact. METHODS:Cancellous bone was assumed to be linearly elastic followed by nonlinearly plastic such as crushable foam behavior. The deformation and failure processes caused by loosening of PSF-nuts, in particular, are addressed by means of finite element analysis. Two finite element models, including anterior (or posterior) lumbar interbody fusion for the human lumbar L4-L5 segments, were constructed. In the respective models, 2 types of PSF were considered such as a solid PSF without relative movement between rod and screw, and a tightened PSF with relative axial movement of the rod between them due to the slight loosening of 2 nuts of L4. RESULTS:The slight loosening of nuts showed much greater levels of bone strain with relative motion at the bone-implant interface compared with the PSF with firmly tightened nuts. The loosening 2 of the 4 nuts imposed an excessive burden on the remaining screws. CONCLUSION:By the consideration of the elasto-plateau plastic behavior of cancellous bone and the relative motion at the contact interface between screw and rod, much more exact behaviors of bone failure were predicted. Slight loosening of the nut would cause a possible risk of segmental instability. With difficulty in either tightening the nut firmly during actual operation or keeping the nut-locking mechanism functioning perfectly in the postoperative state, an enhanced design methodology with more effective locking mechanism is required. Slight PSF-nut loosening may increase risks of failure processes such as rod migration, rod breakage, screw breakage, screw loosening or cage loosening. Different mechanisms however, can be considered; rod breakage and screw breakages are related to the higher stress level of the rod and screw while rod migration is associated with slight nut-loosening. Especially, in the case of a nonsymmetric nut-loosening the risk would be increased. Thus, further study is necessary for improving the current design of PSFs.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Kim Y,Kim TWdoi
10.1097/BRS.0b013e3181b6258asubject
Has Abstractpub_date
2010-03-15 00:00:00pages
599-606issue
6eissn
0362-2436issn
1528-1159journal_volume
35pub_type
杂志文章相关文献
SPINE文献大全abstract:STUDY DESIGN:A combined in vitro and finite-element analysis was completed to assess the biomechanical effect of a new interspinous implant on the lumbar spine. OBJECTIVE:The aim was to investigate the effect of an interspinous implant on the biomechanical behavior of a vertebral segment. METHODS:An in vitro study on...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3180b9f429
更新日期:2007-07-15 00:00:00
abstract::Lumbar spinal flexion and extension motion was measured radiographically and from the back surface curvature in 42 patients with low-back pain to determine whether the surface measurements provided accurate measurement of the total lumbar spinal motion and its distribution by vertebral level. Also, a biomechanical mod...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198705000-00009
更新日期:1987-05-01 00:00:00
abstract:STUDY DESIGN:Histologic analysis of intervertebral disc (IVD) in three types of transgenic mice. OBJECTIVE:To investigate the role of Wnt/β-catenin signaling in regulation of IVD development and organization. SUMMARY OF BACKGROUND DATA:β-catenin dependent Wnt signaling is one of the central regulators in cartilage de...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181f52cb5
更新日期:2011-04-15 00:00:00
abstract:STUDY DESIGN:A cross-sectional study to develop a cultural adaptation of the Marathi-neck disability index (NDI) and to investigate its validity and reliability. OBJECTIVE:To conduct a study concerning the cultural adaptation of the NDI and investigate the validity and reliability of its Marathi version in patients wi...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000000681
更新日期:2015-01-15 00:00:00
abstract:STUDY DESIGN:Prognostic study-case controlled. OBJECTIVE:Describe the rate of neurologic complications in adult spinal deformity surgery and describe the effect of these complications on clinical outcomes. SUMMARY OF BACKGROUND DATA:The incidence of neurologic complications and the risk factors for neurologic complic...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001774
更新日期:2017-03-15 00:00:00
abstract::Knowledge of the normal movements of whole lumbar spine and lumbosacral joint is important for evaluating clinical pathologic conditions that may potentially produce unstable situations in these regions. At present there are few studies that report systemic three-dimensional movement analysis of these regions. The pur...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198911000-00020
更新日期:1989-11-01 00:00:00
abstract::This study examined the role of facet joint morphology in the etiology of both degenerative spondylolisthesis and isthmic spondylolysis. To this end, the axial facet joint morphology of the lower lumbar spine in a normal population and in populations of patients with spinal stenosis or degenerative spondylolisthesis a...
journal_title:Spine
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:STUDY DESIGN:A randomized controlled design superimposed on treatment as usual was used to compare the effects of a cognitive-behavior intervention aimed at preventing chronicity with two different forms of information. OBJECTIVE:To develop a coping-oriented preventive intervention applicable in primary care, and to c...
journal_title:Spine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007632-200011010-00017
更新日期:2000-11-01 00:00:00
abstract:STUDY DESIGN:An experimental animal study. OBJECTIVE:To investigate the relationship between pain-related behavior and the expression of neurotrophic factors in the dorsal root ganglion (DRG) and spinal cord (SC) using a nucleus pulposus (NP) rat model. SUMMARY OF BACKGROUND DATA:Neurotrophic factors are released fro...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002223
更新日期:2018-01-01 00:00:00
abstract:STUDY DESIGN:A prospective study of anterior transarticular screw (ATS) fixation patients. OBJECTIVE:To develop a method to determine screw tip position through plain radiography after percutaneous ATS fixation to prevent occipitocervical joint (OCJ) violation. SUMMARY OF BACKGROUND DATA:No studies using plain radiog...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001508
更新日期:2016-09-01 00:00:00
abstract:STUDY DESIGN:An in vitro biomechanical investigation to quantify the endplates resistance to compressive loads, in the thoracic and lumbar spine. Comparisons were made to determine the regional strength of the endplate, the optimal size and geometry of interbody support, and the effects of endplate removal on structura...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000143623.18098.e5
更新日期:2004-11-01 00:00:00
abstract:STUDY DESIGN:A study of mechanically induced herniation in punctured ovine discs followed by structural analysis. OBJECTIVE:To investigate whether an annular puncture influences the path that herniation takes by providing direct passage for nucleus through the annulus and therefore whether it increases the risk of acu...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002336
更新日期:2018-04-01 00:00:00
abstract::Two-staged anterior and posterior spine fusion with instrumentation was evaluated in 17 cerebral palsy patients, ages 11 to 30 years. Functional benefits included improved sitting balance and, in ambulators, no loss of independence. Curve correction averaged 60%. The pseudarthrosis rate of 18% was lower than previousl...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198211000-00010
更新日期:1982-11-01 00:00:00
abstract:STUDY DESIGN:A retrospective cohort study of a prospectively collected surgical database. OBJECTIVE:The aim of this study was to investigate the effect of smoking on 30-day morbidity and mortality in patients undergoing surgery for adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA:There is conflicting evidence...
journal_title:Spine
pub_type: 杂志文章,多中心研究
doi:10.1097/BRS.0000000000001795
更新日期:2017-04-01 00:00:00
abstract:STUDY DESIGN:A prospective follow-up study. OBJECTIVE:Assessment of the relation between accomplishment of pain relief through percutaneous vertebroplasty (PVP) in painful osteoporotic vertebral compression fractures (OVCFs) and the cemented fraction of the vertebral body and subsequent determination of the optimal in...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e318254871c
更新日期:2012-09-15 00:00:00
abstract:STUDY DESIGN:Systematic literature review. OBJECTIVE:To determine the options, indications, and outcomes for conventional radiotherapy and radiosurgery for metastatic spine disease. METHODS:Three research questions were determined through a consensus among a multidisciplinary panel of spine oncology experts. A system...
journal_title:Spine
pub_type: 杂志文章,评审
doi:10.1097/BRS.0b013e3181b8b6f5
更新日期:2009-10-15 00:00:00
abstract:STUDY DESIGN:Retrospective review and prospective follow-up of 88 patients who had decompressive laminectomy with or without fusion from 1983 to 1986. OBJECTIVE:To determine the 7- to 10-year outcome of surgery for degenerative lumbar spinal stenosis. SUMMARY OF BACKGROUND DATA:There is limited information on the imp...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199601010-00022
更新日期:1996-01-01 00:00:00
abstract::A patient with adult idiopathic scoliosis who was successfully treated with posterior spinal fusion with segmental instrumentation from T3 to L4 is presented. One year after surgery fractures of both L4 pedicles developed, which were managed nonoperatively. Clinical union was achieved in 2 months and the patient was f...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199307000-00016
更新日期:1993-07-01 00:00:00
abstract:STUDY DESIGN:Two case reports of telangiectatic osteosarcoma treated with complete segmental resection of the spine, including the spinal cord. OBJECTIVES:To report the en bloc tumor excision, including the spinal cord, for telangiectatic osteosarcoma, and discuss the indication of cord transection and influence after...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000200132.59292.4b
更新日期:2006-02-15 00:00:00
abstract::Effects of subject positions on range and repeatability of thoracic and lumbar forward flexion, extension, and lateral flexion were studied. Inclinometric methods were used, and 27 subjects were measured by two trained testers. No great differences in repeatability and range of movements were found between measurement...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199109000-00016
更新日期:1991-09-01 00:00:00
abstract:STUDY DESIGN:Basic scientific investigation using radiologic, histochemical, and microscopic dissection techniques. OBJECTIVE:To document the process of mechanically induced disc herniation from repetitive loading exposure. SUMMARY OF BACKGROUND DATA:Current knowledge of the mechanism of disc herniation is limited to...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31815b64f5
更新日期:2007-12-01 00:00:00
abstract:STUDY DESIGN:A case report. OBJECTIVE:To describe an effective surgical option for sacral tuberculosis (TB). SUMMARY OF BACKGROUND DATA:Sacral TB is a rare cause of low back pain. A differential diagnosis of TB should always be made, especially in India where TB cases are on a rampant rise with increasing drug resist...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3182540579
更新日期:2012-06-15 00:00:00
abstract:STUDY DESIGN:Prospective cross-sectional study. OBJECTIVE:To determine the health-related quality of life (HRQoL) of adolescent idiopathic scoliosis (AIS) patients undergoing bracing, previously braced and observation only. SUMMARY OF BACKGROUND DATA:HRQoL is an important treatment outcome measure for AIS. A poor HRQ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002918
更新日期:2019-05-15 00:00:00
abstract:STUDY DESIGN:Retrospective analysis of national insurance billing database. OBJECTIVE:To examine trends in reoperation after single-level lumbar discectomy. SUMMARY OF BACKGROUND DATA:Lumbar discectomy is the most commonly performed procedure for treatment of radiculopathy caused by disc herniation. Randomized clinic...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001855
更新日期:2017-04-15 00:00:00
abstract:STUDY DESIGN:A prospective clinical research article. OBJECTIVE:The primary goals were to determine (1) radiation exposure to the spine surgeon with the use of an intraoperative 3-dimensional imaging system and (2) to define the safe distance from the computed tomographic scanner. SUMMARY OF BACKGROUND:Intraoperative...
journal_title:Spine
pub_type: 临床试验,杂志文章
doi:10.1097/BRS.0b013e31825786d8
更新日期:2012-08-01 00:00:00
abstract::Bilateral paraspinal electromyogram (EMG) at levels L1-L2 and L4-L5, and abdominal EMG of a group of 20 low-back pain patients were compared to those of a group of 20 pain-free controls during flexion, extension, lateral bending to right and left, and rotation to right and left. The results showed no significant left-...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198710000-00012
更新日期:1987-10-01 00:00:00
abstract:STUDY DESIGN:Case report. OBJECTIVE:We present a case of isolated primary epidural lumbar Ewing sarcoma and review the current literature on the standard management. We also propose laminoplasty as safe procedure in this patient population that can provide good stabilization in young people. SUMMARY OF BACKGROUND DAT...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001246
更新日期:2016-03-01 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::In 30 patients undergoing Cotrel-Dubousset instrumentation, computerized tomography was performed before and after surgery. The RAsag-angle was measured for each vertebral level. Coronal and sagittal translation were evaluated in the same computerized tomographic scans by means of a new method. Based on the hooks used...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199208001-00009
更新日期:1992-08-01 00:00:00
abstract:STUDY DESIGN:Case series. OBJECTIVE:Evaluation of ultrasound and nerve stimulation-guided L5 nerve root block technique. SUMMARY OF BACKGROUND DATA:Ultrasound-guided peripheral nerve block has become clinically applied. However, selective lumbosacral nerve root block is conducted under radiographic guidance, which in...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181b43c62
更新日期:2009-11-15 00:00:00