The effect of posterior non-fusion instrumentation on segmental shear loading of the lumbar spine.
Orthop Traumatol Surg Res
; 100(5): 461-7, 2014 Sep.
Article
en En
| MEDLINE
| ID: mdl-25106101
ABSTRACT
BACKGROUND:
Lumbar stenosis and facet osteoarthritis represent indications for decompression and instrumentation. It is unclear if degenerative spondylolisthesis grade I with a remaining disc height could be an indication for non-fusion instrumentation. The purpose of this study was to determine the influence of a mobile pedicle screw based device on lumbar segmental shear loading, thus simulating the condition of spondylolisthesis. MATERIALS ANDMETHODS:
Six human cadaver specimens were tested in 3 configurations intact L4-L5 segment, then facetectomy plus undercutting laminectomy, then instrumentation with lesion. A static axial compression of 400 N was applied to the lumbar segment and anterior displacements of L4 on L5 were measured for posterior-anterior shear forces from 0 to 200 N. The slope of the loading curve was assessed to determine shear stiffness.RESULTS:
Homogenous load-displacement curves were obtained for all specimens. The average intact anterior displacement was 1.2 mm. After lesion, the displacement increased by 0.6mm compared to intact (P=0.032). The instrumentation decreased the displacement by 0.5 mm compared to lesion (P=0.046). The stiffness's were 162 N/mm for intact, 106 N/mm for lesion, 148 N/mm for instrumentation. The difference was not significant between instrumented and intact segments (P=0.591).CONCLUSIONS:
Facetectomy plus undercutting laminectomy decreases segmental shear stiffness and increases anterior translational L4-L5 displacement. Shear stiffness of the instrumented segment is higher with the device and anterior displacements under shear loading are similar to the intact spine. This condition could theoretically be interesting for the simulation of non-fusion instrumentation in degenerative spondylolisthesis.Palabras clave
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Base de datos:
MEDLINE
Asunto principal:
Prótesis e Implantes
/
Espondilolistesis
/
Soporte de Peso
/
Vértebras Lumbares
Idioma:
En
Revista:
Orthop Traumatol Surg Res
Año:
2014
Tipo del documento:
Article