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논문 기본 정보

자료유형
학술저널
저자정보
Craig A. Kuhns (Lakeway Regional Hospital) Jonathan A. Harris (A Division of Globus Medical) Mir M. Hussain (A Division of Globus Medical) Aditya Muzumdar (A Division of Globus Medical) Brandon S. Bucklen (A Division of Globus Medical) Saif Khalil (A Division of Globus Medical)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.11 No.6
발행연도
2017.1
수록면
854 - 862 (9page)

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Study Design: In vitro biomechanical investigation. Purpose: To compare the biomechanics of integrated three-screw and four-screw anterior interbody spacer devices and traditional techniques for treatment of degenerative disc disease. Overview of Literature: Biomechanical literature describes investigations of operative techniques and integrated devices with four dual-stacked, diverging interbody screws; four alternating, converging screws through a polyether-ether-ketone (PEEK) spacer; and four converging screws threaded within the PEEK spacer. Conflicting reports on the stability of stand-alone devices and the influence of device design on biomechanics warrant investigation. Methods: Fourteen cadaveric lumbar spines were divided randomly into two equal groups (n=7). Each spine was tested intact, after discectomy (injured), and with PEEK interbody spacer alone (S), anterior lumbar plate and spacer (AP+S), bilateral pedicle screws and spacer (BPS+S), circumferential fixation with spacer and anterior lumbar plate supplemented with BPS, and three-screw (SA3s) or four-screw (SA4s) integrated spacers. Constructs were tested in flexion-extension (FE), lateral bending (LB), and axial rotation (AR). Researchers performed one-way analysis of variance and independent t -testing (p ≤0.05). Results: Instrumented constructs showed significantly decreased motion compared with intact except the spacer-alone construct in FE and AR (p ≤0.05). SA3s showed significantly decreased range of motion (ROM) compared with AP+S in LB (p ≤0.05) and comparable ROM in FE and AR. The three-screw design increased stability in FE and LB with no significant differences between integrated spacers or between integrated spacers and BPS+S in all loading modes. Conclusions: Integrated spacers provided fixation statistically equivalent to traditional techniques. Comparison of three-screw and four-screw integrated anterior lumbar interbody fusion spacers revealed no significant differences, but the longer, larger-diameter interbody spacer with three-screw design increased stabilization in FE and LB; the diverging four-screw design showed marginal improvement during AR.

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