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Biomechanical effects of posterior pedicle screw-based instrumentation using titanium versus carbon fiber reinforced PEEK in an osteoporotic spine human cadaver model.
Clinical Biomechanics ( IF 1.8 ) Pub Date : 2020-08-15 , DOI: 10.1016/j.clinbiomech.2020.105153
Stavros Oikonomidis 1 , Johannes Greven 2 , Jan Bredow 1 , Madita Eh 1 , Andreas Prescher 3 , Horst Fischer 4 , Johannes Thüring 5 , Peer Eysel 1 , Frank Hildebrand 2 , Philipp Kobbe 2 , Max Joseph Scheyerer 1 , Christian Herren 2
Affiliation  

Background

Aim of this biomechanical investigation was to compare the biomechanical effects of a carbon fiber reinforced PEEK and titanium pedicle screw/rod device in osteoporotic human cadaveric spine.

Methods

Ten human fresh-frozen cadaveric lumbar spines (L1-L5) have been used and were randomized into two groups according to the bone mineral density. A monosegmental posterior instrumentation (L3-L4) using titanium pedicle screws and rods was carried out in group A and using carbon fiber reinforced PEEK in group B. A cyclic loading test was performed at a frequency of 3 Hz, starting with a peak of 500 N for the first 2000 cycles, up to 950 N for 100,000 cycles under a general preload with 100 N. All specimens were evaluated with regard to a potential collapse of the implanted pedicle screws. A CT supported digital measurement of cavities around the pedicle at 3 defined measuring points was performed. Finally, the maximum zero-time failure load of all specimens was determined using a universal testing machine (80% Fmax).

Findings

Regarding maximum axial force (group A: 2835 N, group B: 3006 N, p = 0.595) and maximum compression (group A: 11.67 mm, group B: 15.15 mm, p = 0.174) no statistical difference could be shown between the two groups. However, significant smaller cavity formation around the pedicle screws could be observed in group B (p = 0.007), especially around the screw tip (p < 0.001).

Interpretation

Carbon fiber reinforced PEEK devices seem to be advantageous in terms of microscopic screw loosening compared to titanium devices.



中文翻译:

在骨质疏松脊柱人体尸体模型中,使用钛与碳纤维增强的PEEK进行后椎弓根螺钉器械的生物力学效应。

背景

这项生物力学研究的目的是比较碳纤维增强的PEEK和钛合金椎弓根螺钉/棒器械在骨质疏松性人体尸体脊柱中的生物力学效果。

方法

已使用十个人新鲜冷冻尸体腰椎(L1-L5),并根据骨矿物质密度随机分为两组。在A组中使用钛合金椎弓根螺钉和棒进行单节后路器械(L3-L4),在B组中使用碳纤维增强的PEEK。以3 Hz的频率进行循环载荷测试,峰值为500在最初的2000个循环中,N为100 N,在一般预紧力为100 N的情况下,最大为100,000个循环中为950N。对所有样品的植入椎弓根螺钉可能塌陷进行评估。在3个定义的测量点上进行了CT支持的椎弓根周围腔的数字测量。最后,使用万能试验机确定所有样品的最大零时失效载荷(最大F%为80%)。

发现

关于最大轴向力(A组:2835 N,B组:3006 N,p  = 0.595)和最大压缩力(A组:11.67 mm,B组:15.15 mm,p  = 0.174),两者之间没有统计学差异组。但是,在B组中可以观察到椎弓根螺钉周围明显较小的空腔形成(p  = 0.007),尤其是在螺钉尖端周围(p  <0.001)。

解释

碳纤维增强的PEEK装置在微观螺钉松动方面似乎比钛装置更具优势。

更新日期:2020-08-20
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