| Title |
EUROSPINE 2016 FULL PAPER AWARD: Wire cerclage can restore the stability of the thoracic spine after median sternotomy: an in vitro study with entire rib cage specimens
|
|---|---|
| Published in |
European Spine Journal, September 2016
|
| DOI | 10.1007/s00586-016-4768-x |
| Pubmed ID | |
| Authors |
Christian Liebsch, Nicolas Graf, Hans-Joachim Wilke |
| Abstract |
The influence of the anterior rib cage on the stability of the human thoracic spine is not completely known. One of the most common surgical interventions on the anterior rib cage is the longitudinal median sternotomy and its fixation by wire cerclage. Therefore, the purpose of this in vitro study was to examine, if wire cerclage can restore the stability of the human thoracic spine after longitudinal median sternotomy. Six fresh frozen human thoracic spine specimens (C7-L1, 56 years in average, range 50-65), including the intact rib cage without intercostal muscles, were tested in a spinal loading simulator and monitored with an optical motion tracking system. While applying 2 Nm pure moment in flexion/extension (FE), lateral bending (LB), and axial rotation (AR), the range of motion (ROM) and neutral zone (NZ) of the functional spinal units of the thoracic spine (T1-T12) were studied (1) in intact condition, (2) after longitudinal median sternotomy, and (3) after sternal closure using wire cerclage. The longitudinal median sternotomy caused a significant increase of the thoracic spine ROM relative to the intact condition (FE: 12° ± 5°, LB: 18° ± 5°, AR: 25° ± 10°) in FE (+12 %) and AR (+22 %). As a result, the sagittal cut faces of the sternum slipped apart visibly. Wire cerclage fixation resulted in a significant decrease of the ROM in AR (-12 %) relative to condition after sternotomy. ROM increased relative to the intact condition, in AR even significantly (+8 %). The NZ showed a proportional behavior compared to the ROM in all loading planes, but it was distinctly higher in FE (72 %) and in LB (82 %) compared to the ROM than in AR (12 %). In this in vitro study, the longitudinal median sternotomy resulted in a destabilization of the thoracic spine and relative motion of the sternal cut faces, which could be rectified by fixation with wire cerclage. However, the stability of the intact condition could not be reached. Nevertheless, a fixation of the sternum should be considered clinically to avoid instability of the spine and sternal pseudarthrosis. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 50% |
| Members of the public | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 25 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 25 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 20% |
| Student > Master | 3 | 12% |
| Other | 2 | 8% |
| Professor > Associate Professor | 2 | 8% |
| Student > Ph. D. Student | 2 | 8% |
| Other | 3 | 12% |
| Unknown | 8 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 10 | 40% |
| Nursing and Health Professions | 2 | 8% |
| Engineering | 2 | 8% |
| Sports and Recreations | 1 | 4% |
| Psychology | 1 | 4% |
| Other | 1 | 4% |
| Unknown | 8 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 June 2017.
All research outputs
#17,816,222
of 22,888,307 outputs
Outputs from European Spine Journal
#2,265
of 4,646 outputs
Outputs of similar age
#229,658
of 320,716 outputs
Outputs of similar age from European Spine Journal
#20
of 81 outputs
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