Ahmet KARAKASLİ, Didem Venüs YILDIZ, Erdem KUMTEPE, Ceren KIZMAZOĞLU, Hasan HAVITÇIOĞLU

Sağlam kuzu omurgası ile endoskopik diskektomi yapılmış kuzu omurgasının biyomekanik olarak karşılaştırılması

Objectives: Purpose of current study was biomechanical comparison of changes wrought on motion segments after minimally invasive percutan endoscopic discectomized and intact spine. Materials and Methods: We prepared ten fresh-frozen lamb spines were used for this study. The spine of each specimen was dissected between L4-L5. The biomechanical tests for both intact spine and discectomized spine were performed by using axial compression testing machine (AG-I 10 kN, Shimadzu, Japanese). The axial compression was applied to all specimens with the loading speed of 5 mm/min. 8400 N/mm moment was applied to each specimen to achieve flexion and extension motions, right and left bending by a specially designed fixture. Results: In axial compression and flexion tests, the specimens were more stable according to displacement values. The displacement values of sectioned specimens were closer to intact specimens. Only displacement values of left-bending anteroposterior test for both situations were significant (0.05 ≥ P). Conclusion: PTED hasn't biomechanical and cilinical disadvantages. Endoscopic discectomy hadn't any disadvantages in stability. Only anterior-posterior displacement values of left bending test were statistically significant. We consider that cause of these results were due to the fact that all specimens had percutan transforaminal endoscopic discectomy (PTED) from left side.

Anahtar Kelimeler:

Sağlam omurga, endoskopik disektomi; biyomekanik

Biomechanical Comparison Of Intact Lumbar Lamp Spine And Endoscopic Discectomized Lamp Spine

Keywords:

Intact spine, endoscopic discectomy; biomechanics,

PDF

___

Robby DB, Harry HG, Roger H, et al. Tissue-engineered intervertebral discs produce new matrix, maintain disc height, and restore biomechanical function to the rodent spine. Proceedings of the National Academy of Sciences of the United States of America 2011;108:13106-11.
Markus WK, Frank U, Haili W, et al. New In Vivo Animal Model to Create Intervertebral Disc Degeneration and to Investigate the Effects of Therapeutic Strategies to Stimulate Disc Regeneration. Spine 2002;27:2684-90.
Dong LW, Sheng DJ, Li YD. Biologic Response of the Intervertebral Disc to Static and Dynamic Compression In Vitro. Spine 2007;32:2521-28.
Oto M., Holmes L., Rogers K. Surgical treatment of idiopathic adolescent scoliosis. Eklem Hastalık Cerrahisi. 2012; 23(1):30-34.
Vijay S, Ramsin MB, Sukdeb D, et al. Systematic Review of Percutaneous Lumbar Mechanical Disc Decompression Utilizing Dekompressor. Pain Physician 2009;12:589-599.
Sebastian R, Martin K, Harry M, Georgios G. Use of newly developed instruments and endoscopes: full- endoscopic resection of lumbar disc herniations via the interlaminar and lateral transforaminal approach. J Neurosurg Spine 2007;6:521–530.
Gun C, Sang HL, Pramod L, et al. Percutaneous Endoscopic Approach for Highly Migrated Intracanal Disc Herniations by Foraminoplastic Technique Using Rigid Working Channel Endoscope. Spine 2008;33:508-515.
Ching LT, Pang HH, Weng PC, et al. Biomechanical comparison of lumbar spine instability between laminectomy and bilateral laminotomy for spinal stenosis syndrome – an experimental study in porcine model. BMC Musculoskeletal Disorders 2008;9:1-9.
Gerard PV, Todd RL, Mark S, et al. The lumbar facet joint : a review of current knowledge : part 1 : anatomy , biomechanics , and grading. Skeletal Radiology 2011;40:13-23.
Neil RM, Woojin MH, Jesse B, et al. An Injectable Nucleus Pulposus Implant Restores Compressive Range of Motion in the Ovine Disc. Spine 2012;ISSN:15281159.
Daniel G.T. Strange, MEnga,b, Sandie T. Fisher, BEngga, Philip C. Boughton, PhDa, et. al.Restoration of compressive loading properties of lumbar discs with a nucleus implant—a finite element analysis study, The Spine Journal 10 (2010) 602–609
Nandan LN, Dawn ME, Robert LM. Mechanical design criteria for intervertebral disc tissue engineering. Journal of Biomechanics 2010;43:1017-30.
Ana B, Arthur JM, Rosalyn DA, James CI. Effects of enzymatic digestion on compressive properties of rat intervertebral discs. Journal of Biomechanics 2010;43:1067-1073
Jamie RW, Raghu NN, Gunnar BJA. Inclusion of regional poroelastic material properties better predicts biomechanical behavior of lumbar discs subjected to dynamic loading. Journal of Biomechanics 2007;40:1981-87.
Broc, Guy G. MD*; Crawford, Neil R. PhD; Sonntag, Volker K. H. MD Biomechanical Effects of Transthoracic Microdiscectomy, Spine: Volume 22(6), 15 March 1997, pp 605-612
Lu, W. W. PhD*; Luk, K. D. K. FRCS, Glas & Edin, FRACS*; Ruan, D. K. MD+; Fei,Stability of the Whole Lumbar Spine After Multilevel Fenestration and Discectomy. Spine Volume 24(13), 1 July 1999, p 1277
John EO, Kurt ME, Richard GF. Minimally invasive far lateral microendoscopic discectomy for extraforaminal disc herniation at the lumbosacral junction: cadaveric dissection and technical case report. The spine journal official journal of the North American Spine Society 2007; 7:414-421
Kyeong SY, Yong SC. Full endoscopic contralateral transforaminal discectomy for distally migrated lumbar disc herniation. Journal of orthopaedic science official journal of the Japanese Orthopaedic Association 2011;16:263269.
Sebastian R, Martin K, Harry M, Georgios G. Full-Endoscopic Interlaminar and Transforaminal Lumbar Discectomy Versus Conventional Microsurgical Technique. Spine 2008;33:931-939.
Haiyun L, Zheng W. Intervertebral disc biomechanical analysis using the finite element modeling based on medical images. Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society 2006;30:363-370.
D Greg A, Dessislava M, Sherrill LA. The effect of nucleotomy and the dependence of degeneration of human intervertebral disc strain in axial compression. Spine 2011;36:1765-71.
Georg WO, Andreas GN, Hans JW. A New Porcine In Vivo Animal Model of Disc Degeneration. Spine 2009;34:2730-2739.
Myung JK, Sun HL, Eul SJ. Targeted percutaneous transforaminal endoscopic diskectomy in 295 patients : comparison with results of microscopic diskectomy. Surgical Neurology 2007;68:623-631.
Yong A, Sang HL, June HL. Transforaminal percutaneous endoscopic lumbar discectomy for upper lumbar disc herniation : clinical outcome , prognostic factors , and technical consideration. Acta Neurochirurgica 2009;151:1561.
Esen E., Doğramacı Y., Kömürcü M., Biomechanical comparison of fixation of two part osteoporotic neck fracture of proximal humerus using uni-planar and multi-planar Kirschner wire. Eklem Hastalık Cerrahisi. 2009;20(2):114-118