Journal of Korean Neurosurgical Society

  • 제45권3호
  • /
  • Pages.169-175
  • /
  • 2009
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지
DOI QR코드

DOI QR Code

Biomechanical Study of Lumbar Spinal Arthroplasty with a Semi-Constrained Artificial Disc (Activ L) in the Human Cadaveric Spine

  • Ha, Sung-Kon (Department of Neurosurgery, Korea University Medical Center) ;
  • Kim, Se-Hoon (Department of Neurosurgery, Korea University Medical Center) ;
  • Kim, Daniel H. (Department of Neurosurgery, Baylor College of Medicine) ;
  • Park, Jung-Yul (Department of Neurosurgery, Korea University Medical Center) ;
  • Lim, Dong-Jun (Department of Neurosurgery, Korea University Medical Center) ;
  • Lee, Sang-Kook (Department of Neurosurgery, Korea University Medical Center)
  • 발행 : 2009.03.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective : The goal of this study was to evaluate the biomechanical features of human cadaveric spines implanted with the Activ L prosthesis. Methods : Five cadaveric human lumbosacral spines (L2-S2) were tested for different motion modes, i.e. extension and flexion, right and left lateral bending and rotation. Baseline measurements of the range of motion (ROM), disc pressure (DP), and facet strain (FS) were performed in six modes of motion by applying loads up to 8 Nm, with a loading rate of 0.3 Nm/second. A constant 400 N axial follower preload was applied throughout the loading. After the Activ L was implanted at the L4-L5 disc space, measurements were repeated in the same manner. Results : The Activ L arthroplasty showed statistically significant decrease of ROM during rotation, increase of ROM during flexion and lateral bending at the operative segment and increase of ROM at the inferior segment during flexion. The DP of the superior disc of the operative site was comparable to those of intact spine and the DP of the inferior disc decreased in all motion modes, but these were not statistically significant. For FS, statistically significant decrease was detected at the operative facet during flexion and at the inferior facet during rotation. Conclusion : In vitro physiologic preload setting, the Activ L arthroplasty showed less restoration of ROM at the operative and adjacent levels as compared with intact spine. However, results of this study revealed that there are several possible theoretical useful results to reduce the incidence of adjacent segment disease.

키워드

참고문헌

  1. Danielsson AJ, Cederlund CG, Ekholm S, Nachemson AL : The prevalence of disc aging and back pain after fusion extending into the lower lumbar spine. A matched MR study twenty-five years after surgery for adolescent idiopathic scoliosis. Acta Radiol 42 : 187-197, 2001
  2. Dickman CA, Yahiro MA, Lu HT, Melkerson MN : Surgical treatment alternatives for fixation of unstable fractures of the thoracic and lumbar spine : a meta-analysis. Spine 19 (Suppl 20) : S2266-S2273, 1994 https://doi.org/10.1097/00007632-199410151-00003
  3. Dooris AP, Goel VK, Grosland NM, Gilbertson LG, Wilder DG : Load-sharing between anterior and posterior elements in a lumbar motion segment implanted with an artificial disc. Spine 26 : E122-E129, 2001 https://doi.org/10.1097/00007632-200103150-00004
  4. Fernstrom U : Arthroplasty with intercorporal endoprosthesis in herniated disc and in painful disc. Acta Chir Scand Suppl 357 : 154-159, 1966
  5. Fritzell P, Hägg O, Wessberg P, Nordwall A; Swedish Lumbar Spine Study Group : 2001 Volvo Award Winner in Clinical Studies : Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine 26 : 2521-2532; discussion 2532-2534, 2001 https://doi.org/10.1097/00007632-200112010-00002
  6. Gertzbein SD, Holtby R, Tile M, Kapasouri A, Chan KW, Cruickshank B : Determination of a locus of instantaneous centers of rotation of the lumbar disc by moire fringes. A new technique. Spine 9 : 409-413, 1984 https://doi.org/10.1097/00007632-198405000-00015
  7. Goel VK, Weinstein JN, Patwardhan AG : Biomechanics of intact ligamentous spine in Goel VK WJe (ed) : Biomechanics of the Spine : Clinical and Surgical Perspectives. FL : CRC Press, 1990, pp 97-156
  8. Gunzburg R, Mayer HM, Szpalski M, Aebi M : Arthroplasty of the spine : the long quest for mobility. Introduction. Eur Spine J 11 Suppl 2 : S63-S64, 2002
  9. Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH : Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 81 : 519-528, 1999 https://doi.org/10.2106/00004623-199904000-00009
  10. Hitchon PW, Eichholz K, Barry C, Rubenbauer P, Ingalhalikar A, Nakamura S, et al : Biomechanical studies of an artificial disc implant in the human cadaveric spine. J Neurosurg Spine 2 : 339-343, 2005 https://doi.org/10.3171/spi.2005.2.3.0339
  11. Kozak JA, O’Brien JP : Simultaneous combined anterior and posterior fusion. An independent analysis of a treatment for the disabled low-back pain patient. Spine 15 : 322-328, 1990 https://doi.org/10.1097/00007632-199004000-00014
  12. Kumar MN, Baklanov A, Chopin D : Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J 10 : 314-319, 2001 https://doi.org/10.1007/s005860000239
  13. Kumar MN, Jacquot F, Hall H : Long-term follow-up of functional outcomes and radiographic changes at adjacent levels following lumbar spine fusion for degenerative disc disease. Eur Spine J 10 : 309-313, 2001 https://doi.org/10.1007/s005860000207
  14. Lee CK : Accelerated degeneration of the segment adjacent to a lumbar fusion. Spine 13 : 375-377, 1988 https://doi.org/10.1097/00007632-198803000-00029
  15. Moore KR, Pinto MR, Butler LM : Degenerative disc disease treated with combined anterior and posterior arthrodesis and posterior instrumentation. Spine 27 : 1680-1686, 2002 https://doi.org/10.1097/00007632-200208010-00018
  16. Patwardhan AG, Havey RM, Meade KP, Lee B, Dunlap B : A follower load increases the load-carrying capacity of the lumbar spine in compression. Spine 24 : 1003-1009, 1999 https://doi.org/10.1097/00007632-199905150-00014
  17. Ray CD : Threaded titanium cages for lumbar interbody fusions. Spine 22 : 667; discussion 679-680, 1997 https://doi.org/10.1097/00007632-199703150-00019
  18. Schlegel JD, Smith JA, Schleusener RL : Lumbar motion segment pathology adjacent to thoracolumbar, lumbar, and lumbosacral fusions. Spine 21 : 970-981, 1996 https://doi.org/10.1097/00007632-199604150-00013
  19. Seligman JV, Gertzbein SD, Tile M, Kapasouri A : Computer analysis of spinal segment motion in degenerative disc disease with and without axial loading. Spine 9 : 566-573, 1984 https://doi.org/10.1097/00007632-198409000-00006
  20. Szpalski M, Gunzburg R, Mayer M : Spine arthroplasty: a historical review. Eur Spine J 11 Suppl 2 : S65-S84, 2002
  21. Tropiano P, Huang RC, Girardi FP, Cammisa FP Jr, Marnay T : Lumbar total disc replacement. Seven to eleven-year follow-up. J Bone Joint Surg Am 87 : 490-496, 2005 https://doi.org/10.2106/JBJS.C.01345
  22. Whitecloud TSI 3rd, Davis JM, Olive PM : Operative treatment of the degenerated segment adjacent to a lumbar fusion. Spine 19 : 531-536, 1994 https://doi.org/10.1097/00007632-199403000-00007

피인용 문헌

  1. The Changes in Range of Motion after a Lumbar Spinal Arthroplasty with Charite$^{TM}$ in the Human Cadaveric Spine under Physiologic Compressive Follower Preload: A Comparative Study between Load Cont vol.46, pp.2, 2009, https://doi.org/10.3340/jkns.2009.46.2.144
  2. Biomechanics of Disc Degeneration vol.2012, pp.None, 2009, https://doi.org/10.1155/2012/726210
  3. Clinical, radiological, histological and retrieval findings of Activ-L and Mobidisc total disc replacements: a study of two patients vol.21, pp.suppl4, 2009, https://doi.org/10.1007/s00586-011-2141-7
  4. Biomechanical effects of semi-constrained integrated artificial discs on zygapophysial joints of implanted lumbar segments vol.6, pp.6, 2009, https://doi.org/10.3892/etm.2013.1313
  5. The Effects of a Semiconstrained Integrated Artificial Disc on Zygapophyseal Joint Pressure and Displacement vol.39, pp.25, 2009, https://doi.org/10.1097/brs.0000000000000638
  6. ISASS Policy Statement – Lumbar Artificial Disc vol.9, pp.None, 2015, https://doi.org/10.14444/2007
  7. The Current Testing Protocols for Biomechanical Evaluation of Lumbar Spinal Implants in Laboratory Setting: A Review of the Literature vol.2015, pp.None, 2009, https://doi.org/10.1155/2015/506181
  8. Limitations of current in vitro test protocols for investigation of instrumented adjacent segment biomechanics: critical analysis of the literature vol.24, pp.9, 2009, https://doi.org/10.1007/s00586-015-4040-9
  9. Lumbar Arthroplasty: Past, Present, and Future vol.86, pp.2, 2009, https://doi.org/10.1093/neuros/nyz439
  10. Retrospective study on effectiveness of Activ L total disc replacement vol.16, pp.None, 2021, https://doi.org/10.1186/s13018-020-02116-4