Posterior stabilization of degenerative lumbar spondylolisthesis with a Leeds-Keio artificial ligament. A biomechanical analysis in a porcine vertebral model.

ABSTRACT

STUDY DESIGN: The biomechanical characteristics of the Leeds-Keio artificial ligament (Neoligament LTD, England) were assessed in the posterior stabilization of degenerative lumbar spondylolisthesis in a porcine vertebral model. OBJECTIVES: To evaluate the biomechanical properties of this nonrigid system immediately after instrumentation and during cyclic loading. SUMMARY OF BACKGROUND DATA Mochida et al reported an innovative method of posterior stabilization in which the Leeds-Keio artificial ligament was used as a nonrigid instrument. Since 1990, this system has been used successfully to treat a select group of patients with degenerative lumbar spondylolisthesis. METHODS: Five porcine motion segments (L4-L5) were tested in the intact, destabilized, and Leeds-Keio-instrumented conditions. Specimens were loaded in flexion and extension, and construct stiffness was measured during the initial loading cycle and at 250 cycle intervals for 1500 cycles. RESULTS: Biomechanical stability in the model of degenerative lumbar spondylolisthesis was inferior to that in the controls. The instability in the Leeds-Keio group significantly improved immediately after placement and after 1500 cycles. CONCLUSIONS: This system is effective in initially stabilizing an unstable degenerative lumbar spondylolisthesis model and maintains its stabilizing effect during cyclic loading. Therefore, it can offer patients with degenerative lumbar spondylolisthesis in the late static stage several advantages over other treatment methods.