Análise Biomecânica Da Laminectomia Dorsal Funckquist B Entre As Vértebras Cervicais 6 E 7 Em Cães
Data
2020-06-04
Autores
Galindez, Julian Andres Sanjuan
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A laminectomia cervical dorsal é um procedimento cirúrgico realizado para tratar síndromes que causam compressão ou estenose do canal medular. É particularmente utilizada em condições compressivas, únicas ou múltiplas, que afetam as porções dorsais, ventrais e laterais do canal medular e da medula espinhal. A despeito de técnicas menos invasivas como a hemilaminectomia e pediculectomia, apresenta baixa morbidade, bom prognóstico e recuperação na maioria dos casos. O objetivo deste estudo foi comparar a resistência e a amplitude de movimento (ADM) de colunas vertebrais cervicais (CVCS) íntegras de cadáveres caninos com laminectomia entre as vértebras cervicais seis e sete (C6-C7). Quarenta e quatro colunas vertebrais cervicais (C2-T1) de cães de porte grande com peso médio de 26,2 kg e esqueleticamente maduros foram selecionadas mediante radiografia e tomografia computadorizada foi avaliada a resistência mediante a aplicação de força em Newtons (N) e a ADM em milímetros (mm) desde C2 até C7 de um grupo controle (controle flexão) e de um grupo com laminectomia (laminectomia flexão) em flexão ventral. Posteriormente, avaliou-se a resistência e a ADM de um grupo controle (controle extensão) e um grupo laminectomia (laminectomia extensão) em extensão usando teste mecânico destrutivo de ciclo único em 2 pontos. Os resultados numéricos de força para mensurar a resistência, e a ADM das colunas dos dois grupos controle e dos dois grupos laminectomia foram comparados entre si. Os grupos com laminectomia apresentaram valores menores de força independente do teste mecânico realizado (P<0,001). A ADM não foi influenciada pelo uso da laminectomia, independentemente do tipo de ensaio mecânico (flexão ventral ou extensão) ou a sua interação (P<0,05). Não houve interação entre o efeito do fator laminectomia sim ou não (EFL), nem no efeito do ensaio mecânico flexão ventral ou extensão (EMfe) (P<0,05). A laminectomia cervical dorsal funkquist B entre C6-C7 diminui a resistência mecânica com força de carga suprafisiológica, mas não altera a ADM de colunas vertebrais cervicais podendo ser utilizada sem necessidade de estabilização mecânica em cães de grande porte.
Dorsal cervical laminectomy is a surgical procedure performed to treat syndromes that cause compression or stenosis of the spinal canal. It is particularly used in compressive single or multiple conditions which affect the dorsal, ventral and lateral portions of the spinal cavity and spinal cord, despite less invasive techniques such as hemilaminectomy and pediculectomy, it has low morbidity, good prognosis and recovery in most of cases. The aim of this study was to compare the resistance and range of motion (ROM) of intact cervical spine columns (CSCS) from canine cadavers with laminectomy between cervical vertebrae six and seven (C6-C7). Forty-four cervical vertebral columns (C2-T1) of large dogs with an average weight of 26.2 kg and skeletally mature were selected using radiography and computed tomography. The resistance was evaluated by applying force in Newtons (N) and the ROM in millimeters (mm) from C2 to C7. The resistance was evaluated by applying force in Newtons (N) and the ROM in millimeters (mm) from C2 to C7 in a control group (control flexion) and in a group with laminectomy (laminectomy flexion) in ventral flexion. Resistance and ROM of a control group (control extension) and a laminectomy group (laminectomy extension) in extension were evaluated using a single-point destructive mechanical test at 2 points. The numerical results of strength to measure the resistance, and the ROM of the columns of the two control groups and of the two laminectomy groups were compared to each other. The groups with laminectomy showed lower values of strength regardless of the mechanical test performed (P <0.001). ROM was not influenced by the use of laminectomy, regardless of the type of mechanical test (ventral flexion or extension) or its interaction (P <0.05). There was no interaction between the effect of the laminectomy factor yes or no (EFL), nor the effect of the mechanical test on ventral flexion or extension (EMfe) (P <0.05). Dorsal cervical laminectomy funkquist B between C6-C7 decreases mechanical resistance with supraphysiological loading force, but does not alter the ROM of cervical spine and can be used without mechanical stabilization in large dogs.
Dorsal cervical laminectomy is a surgical procedure performed to treat syndromes that cause compression or stenosis of the spinal canal. It is particularly used in compressive single or multiple conditions which affect the dorsal, ventral and lateral portions of the spinal cavity and spinal cord, despite less invasive techniques such as hemilaminectomy and pediculectomy, it has low morbidity, good prognosis and recovery in most of cases. The aim of this study was to compare the resistance and range of motion (ROM) of intact cervical spine columns (CSCS) from canine cadavers with laminectomy between cervical vertebrae six and seven (C6-C7). Forty-four cervical vertebral columns (C2-T1) of large dogs with an average weight of 26.2 kg and skeletally mature were selected using radiography and computed tomography. The resistance was evaluated by applying force in Newtons (N) and the ROM in millimeters (mm) from C2 to C7. The resistance was evaluated by applying force in Newtons (N) and the ROM in millimeters (mm) from C2 to C7 in a control group (control flexion) and in a group with laminectomy (laminectomy flexion) in ventral flexion. Resistance and ROM of a control group (control extension) and a laminectomy group (laminectomy extension) in extension were evaluated using a single-point destructive mechanical test at 2 points. The numerical results of strength to measure the resistance, and the ROM of the columns of the two control groups and of the two laminectomy groups were compared to each other. The groups with laminectomy showed lower values of strength regardless of the mechanical test performed (P <0.001). ROM was not influenced by the use of laminectomy, regardless of the type of mechanical test (ventral flexion or extension) or its interaction (P <0.05). There was no interaction between the effect of the laminectomy factor yes or no (EFL), nor the effect of the mechanical test on ventral flexion or extension (EMfe) (P <0.05). Dorsal cervical laminectomy funkquist B between C6-C7 decreases mechanical resistance with supraphysiological loading force, but does not alter the ROM of cervical spine and can be used without mechanical stabilization in large dogs.
Descrição
Palavras-chave
Biomecânica, Cão, Descompressão dorsal, Coluna vertebral