Biomechanical study on the effect of five different lumbar reconstruction techniques on adjacent-level intradiscal pressure and lamina strain.
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概要
- 論文の詳細を見る
OBJECT: The objectives of this study were to compare the biomechanical effects of five lumbar reconstruction models on the adjacent segment and to analyze the effects of three factors: construct stiffness, sagittal alignment, and the number of fused segments. METHODS: Nondestructive flexion-extension tests were performed by applying pure moments to 10 calf spinal (L3-S1) specimens. One-segment (L5-6) or two-segment (L5-S1) posterior fusion methods were simulated: 1) one-segment posterolateral fusion (PLF); 2) one-segment PLF with interbody fusion cages (one-segment PLIF/PLF); 3) two-segment PLF; 4) two-segment PLIF/PLF; and 5) two-segment PLF in kyphosis (two-segment kyphotic PLF). The range of motion (ROM) of the reconstructed segments, intradiscal pressure (IDP), and lamina strain in the upper (L4-5) adjacent segment were analyzed. The ROM was significantly decreased in the PLIF/PLF models compared with that in the PLF alone models after both the one- and two-segment fusions. If the number of fused segments was increased, the pressure and strains were also increased in specimens subjected to the PLIF/PLF procedure, more so than the PLF-alone procedure. In the one-segment PLIF/PLF model the authors observed a reduced IDP and lamina strain compared with those in the kyphotic two-segment PLF model despite the latter's higher levels of initial stiffness. CONCLUSIONS: If the number of fused levels can be reduced by using PLIF to correct local kyphosis, then this procedure may be valuable for reducing adjacent-segment degenerative changes.
- American Association of Neurological Surgeonsの論文
著者
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Minami A
Dep. Of Orthopaedic Surgery Graduate School Of Medicine Hokkaido Univ.
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Minami Akio
北海道大学保健管理センター
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ODA Itaru
Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine
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Minami Akio
Department Of Orthopaedic Surgery Hokkaido Graduate University School Of Medicine
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Ito Manabu
Orthopaedic Surgery Hokkaido Univ. Graduate School Of Medicine
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Abumi Kuniyoshi
Department Of Orthopaedic Surgery Hokkaido University Graduate School Of Medicine
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Arisue Makoto
Oral And Maxillofacial Surgery School Of Dentistry Health Sciences Univ. Of Hokkaido
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Arisue Makoto
Department Of Orthopaedic Surgery Hokkaido University Graduate School Of Medicine
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Arisue Makoto
Department Of Oral Maxillo-facial Surgery School Of Dentistry Health Sciences University Of Hokkaido
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Kotani Yoshihisa
Dept. Of Orthop. Surg. Hokkaido University
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Arisue Makoto
Dep. Of Orthopaedic Surgery Graduate School Of Medicine Hokkaido Univ.
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