Utjecaj ugradnje umjetnoga vratnoga intervertebralnoga diska na biomehaniku vratnoga dijela kralježnice

doctoral thesis

• Title (english): Influence of implementing the artificial cervical intervertebral disc on the biomechanics of the cervical spine
• Author: Ivan Domazet
• Mentor: Miroslav Vukić (mentor)
• Committee member: nije dostupno (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2019-05-10, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

UVOD: U proteklim dvama desetljećima ugradnja umjetnog vratnog intervertebralnog diska postala je jedna od uobičajenih metoda liječenja jednorazinske hernije vratnog intervertebralnog diska. Ipak, utjecaj ugradnje umjetnog diska na biomehaniku vratne kralježnice nije u potpunosti istražen. -----
CILJ: Cilj ovog istraživanja bio je istražiti utjecaj ugradnje umjetnog vratnog intervertebralnog diska na biomehaniku vratnog dijela kralježnice uspoređivanjem poslijeoperacijskog opsega pokreta vratne kralježnice ispitivane skupine s prijeoperacijskim opsegom pokreta te uspoređivanjem poslijeoperacijskog opsega pokreta vratne kralježnice ispitivane skupine s opsegom pokreta vratne kralježnice kontrolne skupine ispitanika. -----
MATERIJAL I METODE: U istraživanju je sudjelovalo 50 ispitanika. Ispitivanu skupinu činilo je 25 ispitanika kojima je, zbog jednorazinske hernije vratnog diska, ugrađen umjetni vratni disk Discover. Kontrolnu skupinu činilo je 25 zdravih ispitanika. Svim pripadnicima ispitivane skupine učinjene su statičke i dinamičke radiografske snimke vratne kralježnice prije operacije, te 3, 6, 12 i 24 mjeseca nakon operacije. Pripadnicima kontrolne skupine učinjene su dinamičke radiografske snimke. Pripadnicima ispitivane skupine određeni su opsezi pokreta vratne kralježnice i opsezi pokreta operiranog vertebrodinamičkog segmenta na svim snimljenim radiogramima, dok je pripadnicima kontrolne skupine određen opseg pokreta vratne kralježnice. Opseg pokreta vratne kralježnice određen je zbrajanjem vrijednosti Cobbova kuta vratne kralježnice pri maksimalnoj fleksiji i maksimalnoj ekstenziji vratne kralježnice, dok je opseg pokreta operiranog vertebrodinamičkog segmenta određen zbrajanjem vrijednosti Cobbova kuta operiranog vertebrodinamičkog segmenta pri maksimalnoj fleksiji i ekstenziji vratne kralježnice. -----
REZULTATI: Naše istraživanje biomehanike vratne kralježnice nakon ugradnje umjetnog vratnog diska Discover pokazalo je da opseg pokreta vratne kralježnice i opseg pokreta operiranog vertebrodinamičkog segmenta rastu nakon vratne artroplastike te godinu dana nakon operacije više ne postoji statistički značajna razlika između prosječne vrijednosti opsega pokreta vratne kralježnice ispitivane i kontrolne skupine, a isto svojstvo zadržano je i dvije godine nakon operacije. Dvije godine nakon operacije nije zabilježen ni jedan slučaj heterotopne osifikacije niti znakovi bolesti pridruženog segmenta kod skupine bolesnika kojima je učinjena ugradnja umjetnog vratnog diska Discover.

Abstract (english)

INTRODUCTION: Over the past two decades, cervical disc arthroplasty has become one of the most common methods of treating one-segmental cervical disc herniation. However, the impact of disc arthroplasty on the biomechanics of the cervical spine hasn’t been fully explored yet. -----
AIM: The objective of this study was to investigate the effect of cervical disc arthroplasty on the biomechanics of the cervical spine by comparing the postoperative range of motion of the cervical spine in a cohort that underwent cervical arthroplasty with the preoperative range of motion, and by comparing the postoperative range of motion of the cervical spine in the cohort that had cervical arthroplasty with the range of motion of the cervical spine in the control group. -----
MATERIAL AND METHODS: 50 respondents took part in the research. The cohort consisted of 25 respondents who had their cervical disc replaced with the Discover, an artificial disc device, due to one-segmental cervical disc herniation. The control group consisted of 25 healthy respondents. All members of the cohort had their static and dynamic cervical radiographs taken before the surgery, and 3, 6, 12, and 24 months after the surgery. Members of the control group had their dynamic cervical radiographs taken. Range of motion of the cervical spine, and the range of motion of the operated functional spinal unit was determined by all radiograms in the cohort that underwent cervical arthroplasty, while the range of motion of the cervical spine was determined in the control group. The range of motion of the cervical spine was determined by adding the value of the Cobb angle of the cervical spine in maximum flexion and extension, whereas the range of motion of the operated functional spinal unit was determined by adding the value of the Cobb angle of the operated functional spinal unit in maximum flexion and extension. -----
RESULTS: Our cervical biomechanical research has shown that the range of motion of the cervical spine and the range of motion of the operated functional spinal unit increase after the Discover artificial cervical disc arthroplasty, and that one year after surgery there is no statistically significant difference between the average value of the range of motion of the cervical spine in the cohort and the control group. In addition, the research has shown that the same properties are retained two years after surgery. No cases of heterotopic ossification or signs of adjacent segment disease were found in the group of patients who underwent the Discover artificial cervical disc arthroplasty at two years post-surgery.

• Keywords: medicina
• Keywords (english): medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:965859
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
• Type of resource: Text
• Extent: 106 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-05 08:27:52