PDF(Pubmed)
Abstract：
The vertebral cage has been widely used in posterior lumbar interbody fusion. The risk of cage dislodgment is high for patients undergoing lumbar fusion surgery. Therefore, the main objective of this study was to use a lumbar fusion model to investigate the effects of cage dislodgment on different cage arrangements after PLIF. Finite element analysis was used to compare three PEEK cage placements, together with the fibula-type cage, with respect to the four kinds of lumbar movements. The results revealed that a horizontal cage arrangement could provide a better ability to resist cage dislodgment. Overall lumbar flexion movements were confirmed to produce a greater amount of cage slip than the other three lumbar movements. The lower part of the lumbar fusion segment could create a greater amount of cage dislodgment for all of the lumbar movements. Using an autograft with a fibula as a vertebral cage cannot effectively reduce cage dislodgment. Considering the maximum movement type in lumbar flexion, we suggest that a horizontal arrangement of the PEEK cage might be considered when a single PEEK cage is placed in the fusion segment, as doing so can effectively reduce the extent of cage dislodgment.
摘要：
椎体融合器已广泛应用于腰椎后路椎间融合术。对于接受腰椎融合手术的患者，笼子移位的风险很高。因此,这项研究的主要目的是使用腰椎融合模型来研究PLIF后笼子移位对不同笼子排列的影响。有限元分析用于比较三种PEEK保持架的位置，连同腓骨型笼子，关于四种腰部运动。结果表明，水平笼布置可以提供更好的抵抗笼移位的能力。经证实，与其他三种腰椎运动相比，整体腰椎屈曲运动产生的保持架滑移量更大。腰椎融合段的下部可以为所有腰椎运动产生更大量的笼子移位。使用带有腓骨的自体移植物作为椎骨笼不能有效地减少笼移位。考虑到腰椎屈曲的最大运动类型，我们建议在融合段中放置单个PEEK笼时，可以考虑PEEK笼的水平布置，这样做可以有效地减少笼子移位的程度。
