Background
Distraction type rods mechanically stabilize the thorax and improve lung growth and function by applying distraction forces at the rib, spine, pelvis, or a combination of locations. However, the amount of stability the rods provide and the amount the thorax needs is unknown.
Methods
Five freshly frozen and thawed cadaveric thoracic spine specimens were tested lateral bending, flexion/extension, and axial rotation in displacement control (1°/sec) to a load limit of ± 5 Nm for five cycles after which a growth-friendly unilateral rod was placed in a simulated rib-to-lumbar attachment along the right side. The specimens were tested again the same modes of bending. From the seven Optotrak Orthopedic Research Pin markers (Northern Digital Inc., Waterloo, ON, Canada) inserted into the top potting to denote T1, and the right pedicles at T2, T4, T5, T8, T9, and T11 and the Standard Needle Tip Pressure Transducers (Gaeltech, Isle of Skye, Scotland) inserted into the T4/T5 and T8/T9 discs, motion, stiffness, and pressure data were calculated. Parameters from the third cycle of the intact case and the construct case were compared using two-tailed paired t-tests with 0.05 as the level of significance.
Results
With the construct attached, the T1–T4 segment showed a 30% increase in NZS during extension (p = 0.001); the T8–T12 segment experienced a 63% reduction in the in-plane ROM during flexion (p = 0.04); and the T8/T9 spinal motion unit had a significant decrease of 24% in EZS during left axial rotation (p = 0.04).
Conclusions
It’s clear the device as tested here does not produce large biomechanical changes, but the balance between providing desired changes while preventing complications remains difficult.
Clinical Relevance
Investigating the biomechanical effect growth-friendly rods have on the thoracic spine could lead to better understanding of treatment outcomes, both positive and negative.
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