CLINICAL AND BIOMECHANICAL ASPECTS OF ANTERIOR INTERBODY FUSION WITH POROUS NITI IMPLANTS
Objective. Basing on experiment biomechanical and clinical studies to determine the optimal method of surgery in patients with vertebral lower thoracic and lumbar fractures using porous NiTi implants. Material and Methods. A method of modeling of comminuted vertebral fractures has been developed. The outcomes after anterior interbody fusion with both porous NiTi implants alone and in combination with pedicle screw fixation and on-bone screw – rod osteosynthesis for comminuted vertebral
... in thoracic and lumbar spine were analyzed in 61 patients. An antimigration technique for implant stabilization was developed and successfully used in 5 patients with comminuted vertebral fractures predominantly in the lower lumbar spine. Patients of this group underwent stabilometry and X-ray tomography for objective appraisal of treatment results. Results. Results of the experimental studies demonstrated that anterior mono- and bisegmental spinal fusion with onbone screw – rod or transpedicular osteosynthesis provides stable fixation, but firmer fixation is achieved by its combination with anterior spinal fusion. Most patients (87.9 %) have good results after anterior interbody fusion with porous NiTi implants. Conclusion. Combination of anterior interbody fusion with porous NiTi implants and on-bone screw – rod osteosynthesis is advisable for unstable fractures and also for early active rehabilitation of patients without external immobilization. Anterior interbody fusion with titanium antimigration screw is advisable for comminuted vertebral fractures predominantly in lower lumbar spine.