Spine · 2002
Internal pressure measurements during burst fracture formation in human lumbar vertebrae.
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Ochia Ruth S, Ching Randal P
Аннотация
STUDY DESIGN: In a laboratory study, 21 human lumbar spine segments were used to determine whether intraosseous pressure increases occur during axial-compressive loading conditions under two displacement rates.
OBJECTIVE: To determine whether an intraosseous pressure rise is associated with burst fracture formation.
SUMMARY OF BACKGROUND DATA: Burst fractures are high-speed injuries usually associated with neurologic deficit. An internal pressure rise has been implicated as a critical factor in burst fracture formation. The authors hypothesize that the internal pressure increases with increasing input velocity.
METHODS: The internal pressure changes were measured in spine segments using two displacement rates: 10 mm/s (slow speed) and 2500 mm/s (high speed). Failure load and energy absorption were determined for both groups. The resultant fracture types were determined from postinjury radiographs.
RESULTS: The initial peak internal pressure decreased from slow- to high-speed tests (P < 0.01). Overall peak pressure, failure load, and energy absorbed at failure were not significantly different. Slow-speed tests resulted in compression fractures, whereas high-speed tests resulted in burst and compression fractures.
CONCLUSIONS: The current research did not support the current theory of burst fracture formation. There was a decrease in measured internal pressure from the slow- to high-speed groups, and burst fractures still were produced. The theory could be potentially modified to suggest that the nucleus entering the vertebral body acts as a wedge, splitting the vertebral body apart and enabling the bony fragments to be pushed into the canal space.
OBJECTIVE: To determine whether an intraosseous pressure rise is associated with burst fracture formation.
SUMMARY OF BACKGROUND DATA: Burst fractures are high-speed injuries usually associated with neurologic deficit. An internal pressure rise has been implicated as a critical factor in burst fracture formation. The authors hypothesize that the internal pressure increases with increasing input velocity.
METHODS: The internal pressure changes were measured in spine segments using two displacement rates: 10 mm/s (slow speed) and 2500 mm/s (high speed). Failure load and energy absorption were determined for both groups. The resultant fracture types were determined from postinjury radiographs.
RESULTS: The initial peak internal pressure decreased from slow- to high-speed tests (P < 0.01). Overall peak pressure, failure load, and energy absorbed at failure were not significantly different. Slow-speed tests resulted in compression fractures, whereas high-speed tests resulted in burst and compression fractures.
CONCLUSIONS: The current research did not support the current theory of burst fracture formation. There was a decrease in measured internal pressure from the slow- to high-speed groups, and burst fractures still were produced. The theory could be potentially modified to suggest that the nucleus entering the vertebral body acts as a wedge, splitting the vertebral body apart and enabling the bony fragments to be pushed into the canal space.