Open AccessCLINICAL AND BIOMECHANICAL ASPECTS OF ANTERIOR INTERBODY FUSION WITH POROUS NITI IMPLANTS
Author(s) -
Р. В. Паськов,
K. S. Sergeyev,
Aleksey Olegovich Faryon
Publication year - 2006
Publication title -
hirurgiâ pozvonočnika
Language(s) - English
Resource type - Journals
eISSN - 2313-1497
pISSN - 1810-8997
DOI - 10.14531/ss2006.1.20-24
Subject(s) - medicine , osteosynthesis , implant , nickel titanium , lumbar , fixation (population genetics) , surgery , spinal fusion , materials science , shape memory alloy , population , environmental health , metallurgy
Objective. Basing on experiment biomechanical and clinical studies to determine the optimal method of surgery in patients with vertebral lower thoracic and lumbar fractures using porous NiTi implants. Material and Methods. A method of modeling of comminuted vertebral fractures has been developed. The outcomes after anterior interbody fusion with both porous NiTi implants alone and in combination with pedicle screw fixation and on-bone screw – rod osteosynthesis for comminuted vertebral fractures in thoracic and lumbar spine were analyzed in 61 patients. An antimigration technique for implant stabilization was developed and successfully used in 5 patients with comminuted vertebral fractures predominantly in the lower lumbar spine. Patients of this group underwent stabilometry and X-ray tomography for objective appraisal of treatment results. Results. Results of the experimental studies demonstrated that anterior mono- and bisegmental spinal fusion with onbone screw – rod or transpedicular osteosynthesis provides stable fixation, but firmer fixation is achieved by its combination with anterior spinal fusion. Most patients (87.9 %) have good results after anterior interbody fusion with porous NiTi implants. Conclusion. Combination of anterior interbody fusion with porous NiTi implants and on-bone screw – rod osteosynthesis is advisable for unstable fractures and also for early active rehabilitation of patients without external immobilization. Anterior interbody fusion with titanium antimigration screw is advisable for comminuted vertebral fractures predominantly in lower lumbar spine.