A Biomechanical Stability Study of Extraforaminal Lumbar Interbody Fusion on the Cadaveric Lumbar Spine SpecimensReportar como inadecuado




A Biomechanical Stability Study of Extraforaminal Lumbar Interbody Fusion on the Cadaveric Lumbar Spine Specimens - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background

Transforaminal lumbar interbody fusion TLIF is an effective surgery for lumbar degenerative disease. However, this fusion technique requires resection of inferior facet joint to provide access for superior facet joint resection, which results in reduced lumbar spinal stability and unnecessary trauma. We have previously developed extraforaminal lumbar interbody fusion ELIF that can avoid back muscle injury with direct nerve root decompression. This study aims to show that ELIF enhances lumbar spinal stability in comparison to TLIF by comparing lumbar spinal stability of L4–L5 range of motion ROM on 12 cadaveric spine specimens after performing TLIF or ELIF.

Methods

12 cadaveric spine specimens were randomly divided and treated in accordance with the different internal fixations, including ELIF with a unilateral pedicle screw ELIF+UPS, TLIF with a unilateral pedicle screw TLIF+UPS, TLIF with a bilateral pedicle screw TLIF+BPS, ELIF with a unilateral pedicle screw and translaminar facet screw ELIF+UPS+TLFS and ELIF with a bilateral pedicle screw ELIF+BPS. The treatment groups were exposed to a 400-N load and 6 N·m movement force to calculate the angular displacement of L4-L5 during anterior flexion, posterior extension, lateral flexion and rotation operation conditions.

Results

The ROM in ELIF+UPS group was smaller than that of TLIF+UPS group under all operating conditions, with the significant differences in left lateral flexion and right rotation by 36.15% and 25.97% respectively. The ROM in ELIF+UPS group was higher than that in TLIF+BPS group. The ROM in the ELIF+UPS+TLFS group was much smaller than that in the ELIF+UPS group, but was not significantly different than that in the TLIF+BPS group.

Conclusions

Despite that TLIF+BPS has great stability, which can be comparable by that of ELIF+UPS. Additionally, ELIF stability can be further improved by using translaminar facet screws without causing more tissue damage to patient.



Autor: Song Guo, Cheng Zeng , Meijun Yan, Yingchao Han, Dongdong Xia, Guixin Sun, Lijun Li, Mingjie Yang , Jun Tan

Fuente: http://plos.srce.hr/



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