STUDY DESIGN: An in vitro biomechanical study. PURPOSE: To evaluate the mechanical properties of the spinal segment in the intact, injured, and stabilized state after fixation by an Arcofix implant. OVERVIEW OF LITERATURE: Several types of thoracolumbar spine injury necessitates anterior instrumentation. The Arcofix plate represents the latest generation of angular stablity systems. The biomechanical properties of these implants have not been sufficiently studied yet. METHODS: A total of ten porcine specimens (levels Th12-L3) were prepared. The tests were performed for intact, injured, and implanted specimens. In each state, the specimen was subjected to a tension load of a prescribed force, and subsequently, twisted by a given angle. The force load was 200 N. The torsion load had a deformation character, i.e., the control variable was the twisting angle and the measured variable was the moment of a couple. The amplitude of the load alternating cycle was 3°. Another parameter that was evaluated was the area of the hysteresis loop. The area corresponds to the deformation energy which is dissipated during the cycle. RESULTS: A statistically significant difference was found between the intact and injured states as well as between the injured and implanted specimens. The statistical evaluation also showed a statistically different value of the hysteresis loop area. In the case of instability, the area decreased to 33% of the physiological value. For the implanted sample, the area increased to 170% of the physiological value. CONCLUSIONS: The Arcofix implant with its parameters appears to be suitable and sufficiently stable for the treatment of the anterior column of the spine.

• Klíčová slova
• Anterior stabilization, Biomechanics, Spine stabilization, Thoracolumbar fracture,
• Publikační typ
• časopisecké články MeSH

STUDY DESIGN: Modern biomaterials and instrumentation have popularised surgery of the thoraco-lumbar spine through an anterior route. The advantage of anterior surgery is that it allows for a direct decompression of the compromised spinal canal. However, the potential for devastating long-term sequelae as a result of complications is high. PURPOSE: The aim of this study was to give a general overview and identify the incidence of vascular complications. OVERVIEW OF LITERATURE: There is limited literature describing the overall incidence and complications of anterior spinal surgery. METHODS: A retrospective review of a prospective database of 1,262 consecutive patients with anterior surgery over a twelve-year period. RESULTS: In our study, 1.58% (n=20) of patients suffered complications. Injury to a major vessel was encountered in 14 (1.11%) cases, of which nine involved an injury to the common iliac vein. In six cases, the original procedure was abandoned due to a life-threatening vascular injury (n=3) and unfavourable anatomy (n=3). CONCLUSIONS: The incidence of vascular and other complications in our study was relatively low. Nevertheless, the potential for devastating long-term sequelae as a result of complications remains high. A thorough knowledge and awareness of normal and abnormal anatomy should be gained before attempting such a procedure, and a vascular surgical assistance especially should be readily accessible. We believe use of access surgeons is mandatory in cases with difficult or aberrant anatomy.

• Klíčová slova
• Anterior thoraco-lumbar approach, Complications, External iliac vein, Left iliac vein, Vascular injury,
• Publikační typ
• časopisecké články MeSH