颈椎前路椎体切除融合术中整体固定支架与颈椎前路钢板和支架的生物力学比较:有限元分析。

PubMed ID
G H
发表日期 2019年Feb月

原始出处 医学监测:国际实验与临床研究医学杂志
Medical science monitor : international medical journal of experimental and clinical research
作者 Ouyang  Pengrong  Lu  Teng  He  Xijing  Gao  Zhongyang  Cai  Xuan  Jin  Zhongmin 

文献标题 颈椎前路椎体切除融合术中整体固定支架与颈椎前路钢板和支架的生物力学比较:有限元分析。
Biomechanical Comparison of Integrated Fixation Cage Versus Anterior Cervical Plate and Cage in Anterior Cervical Corpectomy and Fusion (ACCF): A Finite Element Analysis.
Biomechanical Comparison of Integrated Fixation Cage Versus Anterior Cervical Plate and Cage in Anterior Cervical Corpectomy and Fusion (ACCF): A Finite Element Analysis.

文献摘要

背景颈椎前路钢板笼内固定系统(ACPC)用于颈椎前路椎体切除融合术(ACCF)的并发症较多。本研究旨在将整合式固定支架(IFC)应用于颈椎前路钢板(ACP)内,以消除与ACP相关的并发症。材料与方法建立1个完整的颈椎模型和3个ACCF模拟C3-C7颈椎模型。在ACCF模型中,C5由IFC或ACPC进行共透视和固定。对于每个模型,在C3椎体上施加1.0Nm的弯曲、伸展、侧向弯曲和扭转力矩。记录并分析各节段的运动范围(ROM)及螺钉-椎体界面、植骨块和笼状终板的应力分布。结果C3-C7在不同运动状态下的ROMs无明显差异。IFC模型在屈曲、伸展和侧弯时螺钉-椎体界面上的最大vonmises应力低于ACPC模型,但在旋转时高于ACPC模型。与ACPC模型相比,IFC模型移植骨的最大vonmises应力高于ACPC模型,但在屈曲方面除外。IFC模型显示在所有运动平面上笼形终板界面上的最大vonmises应力较高。结论基于有限元分析,IFC提供了与ACPC相同的C3-C7结构稳定性。与ACPC相比,IFC在螺钉-椎体界面和植骨块上表现出更好的生物力学性能,而在保持架-终板界面的生物力学性能较差。


BACKGROUND Anterior cervical plate and cage fixation system (ACPC) used in anterior cervical corpectomy and fusion (ACCF) is reported to incur excess complications. This study aimed to introduce integrated fixation cage (IFC) into ACCF to eliminate the anterior cervical plate (ACP)-related complications. MATERIAL AND METHODS One validated intact and 3 ACCF-simulated C3-C7 cervical spine models were developed. In ACCF models, C5 was corpectomied and fixed by IFC or ACPC. For each model, 1.0 Nm moments of flexion, extension, lateral bending, and torsion were imposed on the C3 vertebra. The range of motion (ROM) of each segment and the stress distribution on screw-vertebra interface, bone graft, and cage-endplate were recorded and analyzed. RESULTS ROMs of C3-C7 were not different in any motion condition between IFC and ACPC models. The maximal von Mises stress on screw-vertebra interface of the IFC model was lower than that of the ACPC models in flexion, extension, and lateral bending, but higher in rotation. The maximal von Mises stress on bone graft of the IFC model was higher compared with the ACPC models, except in flexion. The IFC model showed a higher maximal von Mises stress on cage-endplate interface in all motion planes. CONCLUSIONS Based on finite element analysis, IFC provided identical C3-C7 construct stability as ACPC. Compared with ACPC, IFC showed better biomechanical performance on screw-vertebra interface and bone graft, but worse biomechanical performance on cage-endplate interface.

BACKGROUND Anterior cervical plate and cage fixation system (ACPC) used in anterior cervical corpectomy and fusion (ACCF) is reported to incur excess complications. This study aimed to introduce integrated fixation cage (IFC) into ACCF to eliminate the anterior cervical plate (ACP)-related complications. MATERIAL AND METHODS One validated intact and 3 ACCF-simulated C3-C7 cervical spine models were developed. In ACCF models, C5 was corpectomied and fixed by IFC or ACPC. For each model, 1.0 Nm moments of flexion, extension, lateral bending, and torsion were imposed on the C3 vertebra. The range of motion (ROM) of each segment and the stress distribution on screw-vertebra interface, bone graft, and cage-endplate were recorded and analyzed. RESULTS ROMs of C3-C7 were not different in any motion condition between IFC and ACPC models. The maximal von Mises stress on screw-vertebra interface of the IFC model was lower than that of the ACPC models in flexion, extension, and lateral bending, but higher in rotation. The maximal von Mises stress on bone graft of the IFC model was higher compared with the ACPC models, except in flexion. The IFC model showed a higher maximal von Mises stress on cage-endplate interface in all motion planes. CONCLUSIONS Based on finite element analysis, IFC provided identical C3-C7 construct stability as ACPC. Compared with ACPC, IFC showed better biomechanical performance on screw-vertebra interface and bone graft, but worse biomechanical performance on cage-endplate interface.


获取全文 10.12659/MSM.913630