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Órgano Oficial del Colegio Medico de Ortopedia en Jalisco y de la Sociedad Uruguaya de Columna Vertebral (SUCVE)

2011, Number 3

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COLUMNA 2011; 1 (3)

Monitorización electrónica en el análisis de la estabilidad de la columna lumbar posterior a una cirugía con y sin instrumentación transpedicular

Granados PI

Language: Spanish
References: 35
Page: 44-51
PDF size: 803.04 Kb.


ABSTRACT

Objective: Describe the biomechanical lumbar spinal after surgery with or without transpedicular instrumentation and electronic system development column behavior to detect ligament deformations to support the clinical interpretation. Material. Signal Express LabView Software, strain gauge, sensors system conditioning card, model for experimentation and placement of specimen, swine column T6-L5, instruments Transpedicular Kripton, equipment and material for surgery system segments. Method. Prior preparation of sensors (string gauge) over a mica rigid (7x30mm) with application of glue cyanocrylate, performs the dissection anatomy in lumbar porcine spinal segment T6-L5 (fresh) segments, are placed in the L1-L2 segment, are placed in the previous longitudinal ligament (all), ligament Interespinoso (LEL), supraespinoso ligament (LSE), which in turn is placed in the model for experimentation, subjecting an axial 10 kg load sensors. First conducted measurements as basal source column without any surgical starting measurements with sessions of movement, which have the same rank and amplitude, 0 ° for the position at rest with the load of 10 kg, 30 ° of flexion, 20 ° in the lumbar extension procedure, maximum before fatigue at 0 ° axial compression. Item once by storing data is to perform the same procedures always adding the procedure which continues (foraminectomy discectomy, hemilaminectomy, laminectomy, transpedicular instrumentation to 1 level in the same segment). Results. Basal measurements showed in a breadth of 0.3 volts, with apparent instability with 0.8 sensor voltage amplitude level left foramen volts with variations in voltage positive. By proceeding with the Discectomy is a variation of the amplitude of 2.0 volts, with variations of negative voltages. The hemilaminectomy increases with an amplitude of 3.0 volts. The laminectomy increases even more until the 3.8 volts, and a marked clinical instability during experiments. Transpedicular Instrumentation in applying sensor shows a correction of instability passing pattern signal amplitude 0.5 positive volts with which shows a correction of instability, but at the same time the value of the voltage sensors shows a shift in the level of voltage indicate the articulation is a rigid, forced and different from those obtained in measurements in basal position. Conclusions: The results translate into a biomechanical, map that allow to analyze an objectively as column behaves to various decompression situations causing instability. In the experimental model each decompression surgical process might destabilize 15-20% and still a rigid instrumentation on a slice through the later fails to restore stability, that 5% is lost by ligament bone material removed.


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