Comparative analysis on biomechanical stability of the
lateral fixation of the upper thoracic vertebrae through the middle axillary
approach and the traditional anterior plate fixation

doi:10.3969/j.issn.2095-4344.2584

Abstract

Abstract:

BACKGROUND: With the comprehensive promotion of spinal internal fixation technology, the remodeling of spinal mechanical stability has attracted more and more attention. Lateral internal fixation via axillary midline transthoracic approach for the treatment of upper thoracic vertebra lesion is a new surgical approach. Currently, the research on the biomechanics of upper thoracic vertebra after fixation is relatively rare.

OBJECTIVE: To evaluate whether the reconstruction of upper thoracic vertebrae via axillary midline transthoracic approach can achieve the requirements of biomechanical stability by biomechanical analysis of three-dimensional motion stability and load-bearing strength of upper thoracic vertebrae in lateral and anterior internal fixation models.

METHODS: The C₇-T₆ spine and bilateral rib cage joint specimens were obtained from 12 human cadaveric bodies, and the three-dimensional motion stability test of the complete upper thoracic vertebrae model was performed and recorded as a complete vertebral body group. Subsequently, the specimens were randomly divided into two groups, and the traditional front plate internal fixation (front internal fixation group) and the axillary line into the thoracic cavity side plate internal fixation models (lateral internal fixation group) were established, respectively, with six specimens in each group. Three-dimensional motion test, vertical pressure test and vertical pressure failure test were performed. This study was approved by the Ethics Committee of Second Affiliated Hospital of Guangxi Medical University (approval No. 2017(KY-0080)).

RESULTS AND CONCLUSION: (1) The load of left vertebral body group under left/right flexion, flexion/posterior extension and left/right rotational motion was smaller than that of lateral internal fixation group and anterior internal fixation group (P < 0.01). The load in the front internal fixation group under left/right rotational motion was smaller than that in the lateral internal fixation group (P < 0.05). There was no significant difference between the left/right flexion and the flexion/rear extension between the anterior internal fixation group and the lateral internal fixation group (P > 0.05). (2) When the load reached 600 N, the vertebral body sinking displacement of the front internal fixation group was smaller than in the lateral internal fixation group [(1.39±0.20), (2.15±0.17) mm, P < 0.01]. (3) There was no significant difference in the maximum intensity load between the anterior internal fixation group and the lateral internal fixation group [(1 839.70±122.45), (1 798.65±120.21) N, P=0.571]. (4) Results showed that the axillary midline transthoracic approach was in the lateral steel plate. The fixation is stable and meets the biomechanical needs of spinal reconstruction.

Key words: upper thoracic vertebra, midaxillary thoracic approach, anterior approach, bone graft, internal fixation, three-dimensional movement, load, strength, biomechanics

CLC Number:

Shi Dongdong, Li Xiaofeng, Xiong Huojie, Hu Feng, Zhao Jinmin, Chen Qianfen.

Comparative analysis on biomechanical stability of the lateral fixation of the upper thoracic vertebrae through the middle axillary approach and the traditional anterior plate fixation [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(15): 2349-2354.

Figures/Tables 4

References

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