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Unilateral Cage-Instrumented Fixation for Lumbar Spine
|關鍵字:||Bone fusion;骨融合;range of motion;degeneration;decompression;fixation;活動度;退化;減壓;固定||出版社:||生物產業機電工程學系所||引用:||1. B. K. Crpress,” Characteristics of physician visits for back symptoms: A National Prospective”, Am. J .Public. Health., vol 73, pp 389-395, 1983. 2. P. G. Shekelle, M. Markovich, and R. Louie,” An epidemiologic study of episodes of back pain care”, Spine., vol 20, pp 1668-1673, 1995. 3. J. W. Frymoya,” Back pain and sciatica”, N .Engl. J. Med., vol 3, pp 293-300, 1988. 4. A. C. Popageogion, G. F. Macfarlane, and E .Thomas,” Psychosocial factors in the workplace- do they predicting new episodes of low back pain?”, Spine., vol 22, pp 1137-1142, 1997. 5. D. Shier, J. L. Butler, R. Lewis, Hole's Human Anatomy and Physiology, 10th ed, McGraw-Hill, 2004. 6. J. L. Berry, J. M, Moran, W. S. Berg, and A. D. Steffee,”A morphometric study of human lumbar and selected thoracic vertebra”, Spine., vol 12, pp 362-366, 1987. 7. M. M. Panjabi, J. Duranceau, V. K. Goel, T. R. 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To investigate how unilateral cage-instrumented posterior lumbar interbody fusion (PLIF) affects degenerative disc disease by comparing the biomechanical characteristics of unilateral and bilateral cage-instrumented PLIF.
Twelve motion segments in sheep lumbar spine specimens were tested for flexion, extension, axial rotation, and lateral bending by nondestructive flexibility test method using a nonconstrained testing apparatus. The specimens were divided into two equal groups. Group 1 received unilateral procedures while group 2 received bilateral procedures. Laminectomy, facetectomy, discectomy, cage insertion and transpedicle screw insertion were performed sequentially after testing the intact status. Changes in range of motion (ROM) and neutral zone (NZ) were compared between unilateral and bilateral cage-instrumented PLIF.
Comparing ROM and NZ between, unilateral cage-instrumented PLIF and bilateral cage-instrumented PLIF revealed similar stability in the sheep spine model. In the unilateral cage-instrumented PLIF group, the destructive and stabilizing procedures did not demonstrate a significant difference between right and left side in the lateral bending and axial rotation direction.
Based on the results of this study, unilateral cage-instrumented PLIF and bilateral cage-instrumented PLIF have similar stability in the sheep spine model. The unilateral approach can substantially reduce exposure requirements. It also offers the biomechanics advantage of construction using anterior column support combined with pedicle screws. The unpleasant effect of couple motion resulting from inherent asymmetry was absent in the unilateral group.
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