Biomechanical effects of the body augmenter for reconstruction of the vertebral body.

Hsiang Ho Chen, Wei Kai Wang, Kung Chia Li, Tain Hsiung Chen

研究成果: 雜誌貢獻文章同行評審

21 引文 斯高帕斯(Scopus)

摘要

STUDY DESIGN: An in vitro biomechanical study of the stabilizing effects of the body augmenter and posterior instrumentation on experimental thoracolumbar fractures with vertebral defects. OBJECTIVE: To evaluate the effects of the body augmenter and instrumentation on the stability of the spine-device construct. SUMMARY OF BACKGROUND DATA: Posterior instrumentations alone are widely used to accomplish spinal reduction and provide stability for an injured spine; however, implant failure rates have been reported to be approximately 20%. Transpedicular discectomy and bone graft has reported only 33% fusion rates. Combined anterior bony strut and posterior instrumentation was a challenge to geriatric patients with vulnerable medical conditions and possible vascular and pulmonary complications. Therefore, a new design, the body augmenter, tries to reconstruct the vertebral body through internal mechanical support and also encourage bony fusion. This study is to evaluate its initial mechanical effects. METHODS: Twenty fresh porcine T11-L3 vertebrae were harvested. The L1 vertebra with one third or one half corpectomy was performed to simulate a fracture injury with vertebral defects. Posterior instrumentation alone (PI group), posterior instrumentation with body augmenters (BA group), and anterior instrumentation with tricortical bony strut and DCP 1 level above and 1 level below the fracture site (DCP group) were applied as treatment strategies. Load-displacement and torque-angle plots were generated and used to calculate axial stiffness and torsional rigidity for these constructs with vertebral fracture at the L1 vertebrae. Axial compression, extension, and flexion tests were performed at intact and spine-device constructs to document spinal stability. RESULTS: The construct stability had a complex association to the device applied. In the one third corpectomy group, the BA group had significantly higher compression stiffness than the PI group. In the one half corpectomy group, the flexion and compression stiffness of the BA group became significantly greater than the PI group, and the extension stiffness is significantly higher than the DCP group. CONCLUSIONS: The body augmenters combined with posterior instrumentation increased the spinal construct stability during compression, flexion, and extension. According to results in this study, the body augmenter could provide a better initial stability of construct and prevent the implant failure of posterior instrumentation and may be a feasible substitute for the anterior role in the future.

原文英語
期刊Spine
29
發行號18
出版狀態已發佈 - 9月 15 2004
對外發佈

ASJC Scopus subject areas

  • 生理學
  • 神經病學(臨床)
  • 骨科和運動醫學

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