Biomechanical evaluation of the MACSTL internal fixator for thoracic spinal stabilization.



Rok publikování 2008
Druh Článek v odborném periodiku
Fakulta / Pracoviště MU

Lékařská fakulta

Obor Traumatologie a ortopedie
Klíčová slova thoracic spine unstable fractures anterior approach
Popis Unstable fractures of the thoracic spine represent a serious social and economic issue. They can lead to persistent consequences and chronic disease. The anatomical and biomechanical characteristics of the thoracic spine are different from all the other spinal parts due to its higher movability. The vertebrae of the chest area are less mobile conferring a higher degree of rigidity to the spine. To destabilize this relatively rigid system, a considerable force is necessary. The treatment of unstable spinal fractures is solely surgical. The decompression of the spinal canal with reposition and stabilization of the fracture is indicated urgently. This intervention is performed mostly from the posterior approach in the first phase. However, the anterior spinal column is the structure responsible for the stability of the spine. Therefore, the recent advances in spine surgery focus on this area of expertise. For this reason, we carried out a bio-mechanical study aimed at assessing the effectiveness of two surgical tactics used. The study consists in comparative experiments performed by computer aided device on segments of pig cadavers. The experiment involves a comparison of segments of thoracic spine under the following conditions: an anatomically intact segment, a spine segment with an artificially created anterior instability, and a segment with an applied internal fixator. The experiment compared the mechanical characteristics of these segments. The experiment has demonstrated that after application of the internal fixator used for stabilization of injured anterior spinal column at defined pre-loading of 200 N, the stability of damaged spinal segment in torsion increased twofold. It was also verified that sufficient stability can be ensured using the Modular Anterior Construct System (MACSTL) implant for ventral stabilization of thoracic spine unstable injuries. Endoscopic application of this implant represents an additional advantage of this surgical procedure.

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