THE REASON OF APPLICATION OF TRANSPEDICULAR DEVICES WITH BALKS MADE OF NITINOL
AND TITANIUM ALLOY IN THE TREATMENT OF PATIENTS WITH SPINAL INJURY 

Usikov Vladimir Dmitrievich, Doctor of medical sciences, professor, chief executive, Medical and technical firm “Sintez” (building 2, 1v Tsentralnaya street, Penza, Russia), E-mail: usikov1952@list.ru
Kuftov Vladimir Sergeevich, Candidate of medical sciences, neurosurgeon, Bryansk City Hospital № 1 (11 Kamozina street, Bryansk, Russia), E-mail: kuftov@mail.ru
Kollerov Mikhail Yur'evich, Doctor of engineering sciences, professor, sub-department of materials science and technology of materials processing, Moscow Aviation Institute (national research university) (4 Volokolamskoe highway, Moscow, Russia), E-mail: kollerov@gmail.com
Gusev Dmitriy Evgen'evich, Candidate of engineering sciences, professor, sub-department of materials science and technology of materials processing, Moscow Aviation Institute (national research university) (4 Volokolamskoe highway, Moscow, Russia), E-mail: gusev-home@mail.ru
Monashenko Dmitriy Nikolaevich, Candidate of medical sciences, head of the department of neurosurgery № 1, City Hospital № 26 (2 Kostyushko street, Saint-Petersburg, Russia), E-mail: d.monashenko@yandex.ru 

616-089.15:611.711 

10.21685/2072-3032-2018-4-7 

Background. The relevance and objectives of the work theoretically investigated the possibility of using beams from nitinol to stabilize the spinal segments is also experimentally used for vertebral fractures in the lower thoracic and lumbar regions.
Materials and methods. Theoretical studies were carried out on the course of an elementary model of the lumbar spine, which simulated a compression fracture, laminectomy and stabilization by a transpedicular device with beams made of titanium or titanium nickelide. Linear and angular displacements of the spinal structures were studied under functional loads with the determination of the stability coefficient. In addition, the maximum stresses occurring in the bone structures of the elements of the transpedicular device were recorded. Theoretical studies have been proven by clinical examples of using a pedicle device with titanium and nitinol beams.
Results. Stability healthy spinal motor segment is 100 %. Calculations showed that at vertebra fracture with damage to various osteoligament columns, a decrease in stability in the vertebral motor segment is observed up to 12 %. The stability of the damaged spinal segment when using nitinol beams increases to 85 % with an isolated fracture of the vertebral body and up to 70% with a fracture of the vertebral body and the defect of its posterior structures. In the case of beams of titanium alloy stability of the segment exceeds 100 %. Nitinol beams retain their performance when deformations exceed 3 %, while for titanium beams there is a danger of fatigue failure or loss of the original shape.
Conclusions. In case of unstable vertebral body fractures with preservation of the posterior osteoligamental column (type B), the use of nitinol beams in the transpedicular device is shown, which improves the biomechanics of the stabilized spine, reduces bone resorption around the screws, creates conditions for proper rehabilitation of patients in the postoperative period and reduces the risk of syndrome of adjacent vertebral motor segments. In case of unstable vertebral body fractures (type B) that required laminectomy and unstable spinal injuries with damage to all osteoligamentous columns (type C), it is necessary to use rigid beams made of titanium alloy in the pedicle device. The intended applications of the material obtained are traumatology, vertebrology, and neurosurgery. 

vertebral fracture, semirigid transpedicular fixation 

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