Lomber stabilizasyon yöntemlerinde poliaksiyel pedikül vidası ile açılanmalı vidanın biyomekanik karşılaştırılması
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Maltepe Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Çalışmamızın amacı günümüzde rutin olarak kullanılan poliaksiyel pedikül vidalarına bağlı kompliksyonlara çözüm olarak tasarlanmış olan açılı transpediküler vida – dübel sistemi ile poliaksiyel pedikül vidalarını biyomekanik olarak karşılaştırmaktır. MATERYAL VE METOD: İn vitro biyomekanik test olarak planlanan bu çalışma Maltepe Üniversitesi Tıp Fakültesi Hastanesi ve Afyonkarahisar Sağlık Bilimleri Üniversitesinde Şubat 2020 ve Nisan 2022 tarihleri arasında gerçekleştirilmiştir. Basit randomizayson yöntemi ile 12 adet poliüretan köpük vertebra modeli seçildi ve 6’sı çalışma grubu ve 6’sı kontrol grubu olarak gruplandırıldı. Biyomekanik test Geratech SJV-5K (Ataşehir,İstanbul,Türkiye) 5000 N’luk motorlu test standında 60 mm/dk hızda eksenel çekme kuvveti uygulanarak yapıldı. Biyomekanik test sonucunda elde edilen çekip çıkarma dayanımı ve rijitlik değerleri her iki grup arasında karılaştırıldı. Ayrıca kullanılan implantların kemik yüzey ile temas eden yüzey alanları hesaplandı. BULGULAR: Çekip çıkarma dayanımı kuvveti değerine bakıldığında çalışma grubu medyan değeri 415 ± 44 N ile kontrol grubu medyan değeri 271 ± 75 N olarak saptandı. Her iki grup arasında çekip çıkarma dayanımları açısından istatistiksel anlamlı fark bulunmuştur (p=0,025). Rijitlik değerine bakıldığında çalışma grubunun medyan değeri 340 ± 43 N/mm ile kontrol grubunun medyan değeri 418 ± 76 N/mm olarak saptandı. Her iki grup arasında rijitlik değerleri açısından istatistiksel anlamlı fark bulunmamıştır (p=0,802). Poliaksiyel vidada kemikle temas yüzey alanı değeri 1078 mm² olarak belirlenmiştir. ATVDS’nin dübel komponentinde yüzey alanı değeri 1616 mm² olarak belirlenmiştir. SONUÇ: Bu çalışmada ortopedi ve travmatolojiye poliaksiyel vidaların yarattığı komplikasyonları azaltmak için tasarlanan açılı transpediküler fiksasyon yöntemi ve bu yöntemle uygulanan ATVDS geliştirilmiş ve poliaksiyel vidalarla biyomekanik olarak karşılaştırılmıştır. Sonuç olarak karşılaştırmalı biyomekanik test sonucunda çalışma grubunun kontrol grubuna göre çekip çıkarma dayanımı açısından %35 oranda daha üstün olduğu saptanmıştır. Ancak rijitlik açısından anlamlı bir fark saptanmamıştır.
OBJECTİVE: The aim of our study is to biomechanically compare polyaxial pedicle screws and the angled transpedicular screw – anchor system, which are designed as a solution to the complications associated with polyaxial pedicle screws. MATERIAL and METHODS: This study, which was planned as an in – vitro biomechanical test, was carried out at Maltepe University Faculty of Medicine Hospital and Afyonkarahisar Health Sciences University between February 2020 and April 2022. İn this study 12 polyurethane foam vertebra models were selected by simple randomization method, 6 of them were grouped as the study group and 6 as the control group. Biomechanical test was performed by applying axial pulling force at 60 mm/min speed on Geratech SJV-5K (Ataşehir, Istanbul, Turkey) 5000 N motorized test stand. The pull-out strength and stiffness values obtained as a result of the biomechanical test which were compared between the two groups. In addition, the bone contact surface areas of the implants were calculated in this study. RESULTS: When the pull-out strength value was examined, the median value of the study group was 415 ± 44 N and the median value of the control group was 271 ± 75 N. A statistically significant difference was found between the two groups in terms of pull-out strengths (p=0.025). For the stiffness value, the median value of the study group was 340 ± 43 N/mm, and the median value of the control group was 418 ± 76 N/mm. There was no statistically significant difference between the two groups in terms of stiffness values (p=0.802). The surface area of contact with the bone in the polyaxial screw was determined as 1078 mm². The surface area value in the anchor component of ATVDS was determined as 1616 mm². CONCLUSION: In this study, the angled transpedicular fixation method designed to reduce the complications caused by polyaxial screws. The ATVDS were developed and compared biomechanically with polyaxial screws. As a result of the biomechanical test, it was determined that the study group was 35% superior to the control group in terms of pull-out strength. However, no significant difference was found in terms of rigidity.
OBJECTİVE: The aim of our study is to biomechanically compare polyaxial pedicle screws and the angled transpedicular screw – anchor system, which are designed as a solution to the complications associated with polyaxial pedicle screws. MATERIAL and METHODS: This study, which was planned as an in – vitro biomechanical test, was carried out at Maltepe University Faculty of Medicine Hospital and Afyonkarahisar Health Sciences University between February 2020 and April 2022. İn this study 12 polyurethane foam vertebra models were selected by simple randomization method, 6 of them were grouped as the study group and 6 as the control group. Biomechanical test was performed by applying axial pulling force at 60 mm/min speed on Geratech SJV-5K (Ataşehir, Istanbul, Turkey) 5000 N motorized test stand. The pull-out strength and stiffness values obtained as a result of the biomechanical test which were compared between the two groups. In addition, the bone contact surface areas of the implants were calculated in this study. RESULTS: When the pull-out strength value was examined, the median value of the study group was 415 ± 44 N and the median value of the control group was 271 ± 75 N. A statistically significant difference was found between the two groups in terms of pull-out strengths (p=0.025). For the stiffness value, the median value of the study group was 340 ± 43 N/mm, and the median value of the control group was 418 ± 76 N/mm. There was no statistically significant difference between the two groups in terms of stiffness values (p=0.802). The surface area of contact with the bone in the polyaxial screw was determined as 1078 mm². The surface area value in the anchor component of ATVDS was determined as 1616 mm². CONCLUSION: In this study, the angled transpedicular fixation method designed to reduce the complications caused by polyaxial screws. The ATVDS were developed and compared biomechanically with polyaxial screws. As a result of the biomechanical test, it was determined that the study group was 35% superior to the control group in terms of pull-out strength. However, no significant difference was found in terms of rigidity.
Açıklama
Anahtar Kelimeler
Lomber stabilizasyon yöntemleri, Poliaksiyel pedikül vidası, Açılanmalı vida, Biyomekanik karşılaştırma
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Najafov, T. (2022). Lomber stabilizasyon yöntemlerinde poliaksiyel pedikül vidası ile açılanmalı vidanın biyomekanik karşılaştırılması. (Yayımlanmamış Uzmanlık Tezi). Maltepe Üniversitesi, Tıp Fakültesi, İstanbul.
