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Biomechanical Comparison of Different Numbers and Configurations of Cross-Links in Long-Segment Spinal Fixation—An Experimental Study in a Porcine Model

STUDY DESIGN: Biomechanical study. OBJECTIVE: Cross-links are a type of common clinical spinal instrumentation. However, the effects of the position and number of cross-links have never been investigated in long-segment spinal fixation, and the variables have not been optimized. We conducted an in v...

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Autores principales: Hsieh, Ming-Kai, Liu, Mu-Yi, Tsai, Tsung-Ting, Lai, Po-Liang, Tai, Ching-Lung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837523/
https://www.ncbi.nlm.nih.gov/pubmed/33511875
http://dx.doi.org/10.1177/2192568221990646
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author Hsieh, Ming-Kai
Liu, Mu-Yi
Tsai, Tsung-Ting
Lai, Po-Liang
Tai, Ching-Lung
author_facet Hsieh, Ming-Kai
Liu, Mu-Yi
Tsai, Tsung-Ting
Lai, Po-Liang
Tai, Ching-Lung
author_sort Hsieh, Ming-Kai
collection PubMed
description STUDY DESIGN: Biomechanical study. OBJECTIVE: Cross-links are a type of common clinical spinal instrumentation. However, the effects of the position and number of cross-links have never been investigated in long-segment spinal fixation, and the variables have not been optimized. We conducted an in vitro biomechanical study by using a porcine long-segment spinal model with 5 different crosslink configurations to determine the optimal construct for clinical practice. METHODS: Five modalities with paired segmental screws from T15-L5 were tested in 20 porcine spines. The spines without cross-links composed the control group, Group A; those with a single cross-link from L2-3 composed Group B; those with 2 cross-links from L1-2 and L3-4 composed Group C; those with 2 cross-links from T15-L1 and L4-5 composed Group D; and those with 3 cross-links from T15-L1, L2-3 and L4-5 composed Group E. Spinal stiffnesses in flexion, extension, lateral bending, and axial rotation were compared among 5 different cross-link configurations in 5-level porcine spinal units. RESULTS: Flexional, extensional and lateral bending stiffnesses did not significantly change with an increasing number of cross-links or positions in the construct. Axial stiffness was significantly increased with 2 cross-links compared to one (P < 0.05) and with placement more distant from the center of the long spinal fixation construct (P < 0.05). CONCLUSIONS: Two cross-links individually placed proximal and distal from the center of a construct is an optimal and efficient configuration to achieve biomechanical stability in non-rigid lumbar spines undergoing long-level fixation.
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spelling pubmed-98375232023-01-14 Biomechanical Comparison of Different Numbers and Configurations of Cross-Links in Long-Segment Spinal Fixation—An Experimental Study in a Porcine Model Hsieh, Ming-Kai Liu, Mu-Yi Tsai, Tsung-Ting Lai, Po-Liang Tai, Ching-Lung Global Spine J Original Articles STUDY DESIGN: Biomechanical study. OBJECTIVE: Cross-links are a type of common clinical spinal instrumentation. However, the effects of the position and number of cross-links have never been investigated in long-segment spinal fixation, and the variables have not been optimized. We conducted an in vitro biomechanical study by using a porcine long-segment spinal model with 5 different crosslink configurations to determine the optimal construct for clinical practice. METHODS: Five modalities with paired segmental screws from T15-L5 were tested in 20 porcine spines. The spines without cross-links composed the control group, Group A; those with a single cross-link from L2-3 composed Group B; those with 2 cross-links from L1-2 and L3-4 composed Group C; those with 2 cross-links from T15-L1 and L4-5 composed Group D; and those with 3 cross-links from T15-L1, L2-3 and L4-5 composed Group E. Spinal stiffnesses in flexion, extension, lateral bending, and axial rotation were compared among 5 different cross-link configurations in 5-level porcine spinal units. RESULTS: Flexional, extensional and lateral bending stiffnesses did not significantly change with an increasing number of cross-links or positions in the construct. Axial stiffness was significantly increased with 2 cross-links compared to one (P < 0.05) and with placement more distant from the center of the long spinal fixation construct (P < 0.05). CONCLUSIONS: Two cross-links individually placed proximal and distal from the center of a construct is an optimal and efficient configuration to achieve biomechanical stability in non-rigid lumbar spines undergoing long-level fixation. SAGE Publications 2021-01-29 2023-01 /pmc/articles/PMC9837523/ /pubmed/33511875 http://dx.doi.org/10.1177/2192568221990646 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Hsieh, Ming-Kai
Liu, Mu-Yi
Tsai, Tsung-Ting
Lai, Po-Liang
Tai, Ching-Lung
Biomechanical Comparison of Different Numbers and Configurations of Cross-Links in Long-Segment Spinal Fixation—An Experimental Study in a Porcine Model
title Biomechanical Comparison of Different Numbers and Configurations of Cross-Links in Long-Segment Spinal Fixation—An Experimental Study in a Porcine Model
title_full Biomechanical Comparison of Different Numbers and Configurations of Cross-Links in Long-Segment Spinal Fixation—An Experimental Study in a Porcine Model
title_fullStr Biomechanical Comparison of Different Numbers and Configurations of Cross-Links in Long-Segment Spinal Fixation—An Experimental Study in a Porcine Model
title_full_unstemmed Biomechanical Comparison of Different Numbers and Configurations of Cross-Links in Long-Segment Spinal Fixation—An Experimental Study in a Porcine Model
title_short Biomechanical Comparison of Different Numbers and Configurations of Cross-Links in Long-Segment Spinal Fixation—An Experimental Study in a Porcine Model
title_sort biomechanical comparison of different numbers and configurations of cross-links in long-segment spinal fixation—an experimental study in a porcine model
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837523/
https://www.ncbi.nlm.nih.gov/pubmed/33511875
http://dx.doi.org/10.1177/2192568221990646
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