Influence of muscle forces on loads in internal spinal fixation devices

被引:35
作者
Rohlmann, A
Bergmann, G
Graichen, F
Mayer, HM
机构
[1] Free Univ Berlin, Dept Orthopaed Surg, Oskar Helene Heim, D-1000 Berlin, Germany
[2] Free Univ Berlin, Oskar Helene Heim, Dept Biomech, Biomech Lab, D-14195 Berlin, Germany
关键词
anterior fusion; internal spinal fixators; load measurement; muscle forces; spine; telemetry;
D O I
10.1097/00007632-199803010-00005
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study design. The loads acting on an internal spinal fixation device were measured in vivo. Objectives. To determine the influence of muscle forces on implant loads. Summary of Background Data. Only limited information exists regarding the loads acting on spinal implants in vivo. Though the muscles greatly influence spinal load, they have been neglected in most studies. Methods. Telemeterized internal spinal fixation devices were used to study the influence of muscle forces on the implant loads in three patients before and after anterior interbody fusion. Results. Contracting abdominal or back muscles in a lying position was found to significantly increase implant loads. Hanging by the hands from wall bars as well as balancing with the hands on parallel bars reduced the implant loads compared with standing; however, hanging by the feet with the head upside down did not reduce implant loads compared with lying in a supine position. When lying on an operating table with only the foot end lowered so that the hips were bent, the patient had different load measurements in the conscious and anesthetized state before anterior interbody fusion. The anesthetized patient evidenced predominately extension moments in both fixators, whereas flexion moments were observed in the right fixator of the conscious patient. After anterior interbody fusion had occurred, the differences in implant loads resulting from anesthesia were small. Conclusions. The muscles greatly influence implant loads. They prevent an axial tensile load on the spine when part of the body weight is pulling, e.g., when the patient is hanging by his hands or feet. The implant loads may be strongly altered when the patient is under anesthesia.
引用
收藏
页码:537 / 542
页数:6
相关论文
共 21 条
[1]  
ANDERSSON GBJ, 1977, ORTHOP CLIN N AM, V8, P85
[2]  
ANDERSSON GBJ, 1977, CLIN ORTHOP RELAT R, P156
[3]  
DICK W, 1989, INTERNAL FIXATION TH, P53
[4]   Patient monitoring system for load measurement with spinal fixation devices [J].
Graichen, F ;
Bergmann, G ;
Rohlmann, A .
MEDICAL ENGINEERING & PHYSICS, 1996, 18 (02) :167-174
[5]   A MYOELECTRICALLY BASED DYNAMIC 3-DIMENSIONAL MODEL TO PREDICT LOADS ON LUMBAR SPINE TISSUES DURING LATERAL BENDING [J].
MCGILL, SM .
JOURNAL OF BIOMECHANICS, 1992, 25 (04) :395-414
[6]   INTRAVITAL WIRELESS TELEMETRY OF AXIAL FORCES IN HARRINGTON DISTRACTION RODS IN PATIENTS WITH IDIOPATHIC SCOLIOSIS [J].
NACHEMSO.A ;
ELFSTROM, G .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1971, A 53 (03) :445-&
[7]  
NACHEMSON A., 1966, CLIN ORTHO RELAT RES, V45, P107
[8]   INVIVO MEASUREMENTS OF INTRADISCAL PRESSURE - DISCOMETRY, A METHOD FOR THE DETERMINATION OF PRESSURE IN THE LOWER LUMBAR DISCS [J].
NACHEMSON, A ;
MORRIS, JM .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1964, 46 (05) :1077-1092
[9]  
NACHEMSON A L, 1976, Spine, V1, P59, DOI 10.1097/00007632-197603000-00009
[10]   ELECTROMYOGRAPHIC STUDIES OF THE LUMBAR TRUNK MUSCULATURE DURING THE DEVELOPMENT OF AXIAL TORQUES [J].
POPE, MH ;
ANDERSSON, GBJ ;
BROMAN, H ;
SVENSSON, M ;
ZETTERBERG, C .
JOURNAL OF ORTHOPAEDIC RESEARCH, 1986, 4 (03) :288-297