Objective To investigate the feasibility and surgical effects of posterior articular process approach for the treatment of L1-L3 lumbar disc herniation.Methods A retrospective study,of17patients with upper lumbar inte...Objective To investigate the feasibility and surgical effects of posterior articular process approach for the treatment of L1-L3 lumbar disc herniation.Methods A retrospective study,of17patients with upper lumbar intervertebml disc展开更多
第三腰椎横突综合征(the third lumbar transverse process syndrome,TLTPS)以急、慢性损伤引起腰部慢性疼痛为主要临床表现,尤其以第三腰椎横突处压痛为最主要的临床表现,本文通过收集、总结近3年来有关TLTPS治疗方法和疗效分析的相关...第三腰椎横突综合征(the third lumbar transverse process syndrome,TLTPS)以急、慢性损伤引起腰部慢性疼痛为主要临床表现,尤其以第三腰椎横突处压痛为最主要的临床表现,本文通过收集、总结近3年来有关TLTPS治疗方法和疗效分析的相关文献,为临床医师提供更有效的治疗方法。展开更多
This study was designed to measure the pressure distribution of the intervertebral disc under different degrees of distraction of the interspinous process, because of a suspicion that the degree of distraction of the ...This study was designed to measure the pressure distribution of the intervertebral disc under different degrees of distraction of the interspinous process, because of a suspicion that the degree of distraction of the spinous process may have a close relationship with the disc load share. Six human cadaver lumbar spine L2-L5 segments were loaded in flexion, neutral position, and extension. The L3-L4 disc load was measured at each position using pressure measuring films. Shape-memory interspinous process implants （SMID） with different spacer heights, ranging in size from 10 to 20 mm at 2 mm increments, were used. It was found that a SMID with a spacer height equal to the distance of the interspinous process in the neutral position can share the biomechanical disc load without a significant change of load in the anterior annulus. An interspinous process stabilizing device （IPD） would not be appropriate to use in those cases with serious spinal stenosis because the over-distraction of the interspinous process by the SMID would lead to overloading the anterior annulus which is a recognized cause of disc degeneration.展开更多
There are few biomechanical studies on Interspinous Process Implants (IPD);however none investigate the amount of wear on spinous processes. Therefore the objective of the present study was to investigate the effect o...There are few biomechanical studies on Interspinous Process Implants (IPD);however none investigate the amount of wear on spinous processes. Therefore the objective of the present study was to investigate the effect of repetitive loading of the IPD Aperius on the spinous processes in a biomechanical porcine model. For comparison, three patients treated surgically with the same device have been followed for one to two years clinically and with image analyses (X-rays, MRI, CT-scans). Four lumbar spines from 6 months old porcine were divided into seven segments, which received IPD. The segments were exposed to 20,000 cyclical loads. Afterwards the deformation (wear) of the segments was registered. The wear of the spinous processes was measured in mm on a following CT-scan. Additionally, the wear of the ex-vivo was compared to that of the spinous processes investigated by CT-scans or X-ray in three patients treated surgically with the same interspinous implant. The mean maximal deformation of porcine specimens was 1.79 mm (SD 0.25) with the largest deformation occurring in the first quarter of the loading (<5000 cycles). The mean wear of the spinous processes after loading was 6.57 mm. A similar level of wear (mean 12.7 mm) of the spinous processes was detected in the patients. The Aperius IPD creates significant wear on the spinous processes in an experimental biomechanical study. Similar wear of the spinous processes is also present in patients treated with the same device post-operatively. How these findings influence the short and long term result of this implant device remains to be investigated in further biomechanical as well as clinical studies. For future development of this type of devices a proper selection of materials and design is essential to minimize wear effects on the spinous processes and thereby increases the possibilities for the devices to function as suggested.展开更多
文摘Objective To investigate the feasibility and surgical effects of posterior articular process approach for the treatment of L1-L3 lumbar disc herniation.Methods A retrospective study,of17patients with upper lumbar intervertebml disc
文摘第三腰椎横突综合征(the third lumbar transverse process syndrome,TLTPS)以急、慢性损伤引起腰部慢性疼痛为主要临床表现,尤其以第三腰椎横突处压痛为最主要的临床表现,本文通过收集、总结近3年来有关TLTPS治疗方法和疗效分析的相关文献,为临床医师提供更有效的治疗方法。
基金supported by the Medical Key Technology Development Program,Nanjing Health Bureau (ZKK08010)
文摘This study was designed to measure the pressure distribution of the intervertebral disc under different degrees of distraction of the interspinous process, because of a suspicion that the degree of distraction of the spinous process may have a close relationship with the disc load share. Six human cadaver lumbar spine L2-L5 segments were loaded in flexion, neutral position, and extension. The L3-L4 disc load was measured at each position using pressure measuring films. Shape-memory interspinous process implants （SMID） with different spacer heights, ranging in size from 10 to 20 mm at 2 mm increments, were used. It was found that a SMID with a spacer height equal to the distance of the interspinous process in the neutral position can share the biomechanical disc load without a significant change of load in the anterior annulus. An interspinous process stabilizing device （IPD） would not be appropriate to use in those cases with serious spinal stenosis because the over-distraction of the interspinous process by the SMID would lead to overloading the anterior annulus which is a recognized cause of disc degeneration.
文摘There are few biomechanical studies on Interspinous Process Implants (IPD);however none investigate the amount of wear on spinous processes. Therefore the objective of the present study was to investigate the effect of repetitive loading of the IPD Aperius on the spinous processes in a biomechanical porcine model. For comparison, three patients treated surgically with the same device have been followed for one to two years clinically and with image analyses (X-rays, MRI, CT-scans). Four lumbar spines from 6 months old porcine were divided into seven segments, which received IPD. The segments were exposed to 20,000 cyclical loads. Afterwards the deformation (wear) of the segments was registered. The wear of the spinous processes was measured in mm on a following CT-scan. Additionally, the wear of the ex-vivo was compared to that of the spinous processes investigated by CT-scans or X-ray in three patients treated surgically with the same interspinous implant. The mean maximal deformation of porcine specimens was 1.79 mm (SD 0.25) with the largest deformation occurring in the first quarter of the loading (<5000 cycles). The mean wear of the spinous processes after loading was 6.57 mm. A similar level of wear (mean 12.7 mm) of the spinous processes was detected in the patients. The Aperius IPD creates significant wear on the spinous processes in an experimental biomechanical study. Similar wear of the spinous processes is also present in patients treated with the same device post-operatively. How these findings influence the short and long term result of this implant device remains to be investigated in further biomechanical as well as clinical studies. For future development of this type of devices a proper selection of materials and design is essential to minimize wear effects on the spinous processes and thereby increases the possibilities for the devices to function as suggested.
