대한의용생체공학회:의공학회지 (Journal of Biomedical Engineering Research)

  • 제38권1호
  • /
  • Pages.9-15
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  • 2017
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  • 1229-0807(pISSN)
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  • 2288-9396(eISSN)
대한의용생체공학회 (The Korean Society of Medical and Biological Engineering)
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Spring rod를 사용한 척추경 나사못과 동반 시술된 Flexible cage의 생체역학적 효과

Biomechanical Efficacy of a Combined Flexible Cage with Pedicle Screws with Spring rods: A Finite Element Analysis

  • 김영현 (부산지방식품의약품안전청 시험분석센터) ;
  • 박은영 (식품의약품안전평가원 의료기기심사부) ;
  • 김원현 (인제대학교 의용공학부) ;
  • 황성필 ((주)바이오스파인) ;
  • 박경우 (광혜병원 신경외과) ;
  • 이성재 (인제대학교 의용공학부)
  • Kim, Y.H. (Center for Food & Drug Analysis, Ministry of Food and Drug Safety) ;
  • Park, E.Y. (Department of Medical Device Evaluation, Ministry of Food and Drug Safety) ;
  • Kim, W.H. (Department of Biomedical Engineering, Inje University) ;
  • Hwang, S.P. (Biospine Co., Ltd) ;
  • Park, K.W. (Department of Neurosurgery, Kwang-Hye Spine Hospital) ;
  • Lee, Sung-Jae (Department of Biomedical Engineering, Inje University)
  • 투고 : 2017.01.11
  • 심사 : 2017.03.05
  • 발행 : 2017.02.28
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초록

Recently, flexible cages have been introduced in an attempt to absorb and reduce the abnormal load transfer along the anterior parts of the spine. They are designed to be used with the pedicle screw systems to allow some mobility at the index level while containing ROM at the adjacent level. In this study, a finite element (FE) study was performed to assess biomechanical efficacies of the flexible cage when combined with pedicle screws with flexible rods. The post-operated models were constructed by modifying the L4-5 of a previously-validated 3-D FE model of the intact lumbar spine (L2-S1): (1) Type 1, flexible cage only; (2) Type 2, pedicle screws with flexible rods; (3) Type 3, interbody fusion cage plus pedicle screws with rigid rods; (4) Type 4, interbody fusion cage plus Type 2; (5) Type 5, Type 1 plus Type 2. Flexion/extension of 10 Nm with a compressive follower load of 400N was applied. As compared to the Type 3 (62~65%) and Type 4 (59~62%), Type 5 (53~55%) was able to limit the motion at the operated level effectively, despite moderate reduction at the adjacent level. It was also able to shift the load back to the anterior portions of the spine thus relieving excessively high posterior load transfer and to reduce stress on the endplate by absorbing the load with its flexible shape design features. The likelihood of component failure of flexble cage remained less than 30% regardless of loading conditions when combined with pedicle screws with flexible rods. Our study demonstrated that flexible cages when combined with posterior dynamic system may help reduce subsidence of cage and degeneration process at the adjacent levels while effectively providing stability at the operated level.

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