کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4050245 1264913 2015 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Augmentation of failed human vertebrae with critical un-contained lytic defect restores their structural competence under functional loading: An experimental study
ترجمه فارسی عنوان
افزایش استروژن های شکست خورده انسانی با نقص بدون ضایعه بدون انسداد مجدد، توانایی ساختاری آنها را در بارۀ عملیاتی، بازسازی می کند: یک مطالعه تجربی
کلمات کلیدی
مهره های آسیب شناسی تقویت سیمان، واکنش ساختاری، مطالعه تجربی، هندسه، تراکم معدنی استخوان
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی ارتوپدی، پزشکی ورزشی و توانبخشی
چکیده انگلیسی


• Failed human vertebrae with lytic defects were cement augmented and tested to failure.
• Resulted change in the vertebral structural competence and geometry was assessed.
• Augmentation bolstered the vertebral compression and shear structural competence.
• However, treated bodies remained 20–100% weaker compared to historical controls.
• Change in vertebral geometry was not correlated with increased cement volume.

BackgroundLytic spinal lesions reduce vertebral strength and may result in their fracture. Vertebral augmentation is employed clinically to provide mechanical stability and pain relief for vertebrae with lytic lesions. However, little is known about its efficacy in strengthening fractured vertebrae containing lytic metastasis.MethodsEighteen unembalmed human lumbar vertebrae, having simulated uncontained lytic defects and tested to failure in a prior study, were augmented using a transpedicular approach and re-tested to failure using a wedge fracture model. Axial and moment based strength and stiffness parameters were used to quantify the effect of augmentation on the structural response of the failed vertebrae. Effects of cement volume, bone mineral density and vertebral geometry on the change in structural response were investigated.FindingsAugmentation increased the failed lytic vertebral strength [compression: 85% (P < 0.001), flexion: 80% (P < 0.001), anterior-posterior shear: 95%, P < 0.001)] and stiffness [(40% (P < 0.05), 53% (P < 0.05), 45% (P < 0.05)]. Cement volume correlated with the compressive strength (r2 = 0.47, P < 0.05) and anterior-posterior shear strength (r2 = 0.52, P < 0.05) and stiffness (r2 = 0.45, P < 0.05). Neither the geometry of the failed vertebrae nor its pre-fracture bone mineral density correlated with the volume of cement.InterpretationVertebral augmentation is effective in bolstering the failed lytic vertebrae compressive and axial structural competence, showing strength estimates up to 50–90% of historical values of osteoporotic vertebrae without lytic defects. This modest increase suggests that lytic vertebrae undergo a high degree of structural damage at failure, with strength only partially restored by vertebral augmentation. The positive effect of cement volume is self-limiting due to extravasation.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Clinical Biomechanics - Volume 30, Issue 6, July 2015, Pages 608–616
نویسندگان
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