185. A novel testing methodology to quantify multidirectional flexibility properties of the lumbar spine

Autor: P. Justin Tortolani, holas Rolle
Rok vydání: 2020
Předmět:
Zdroj: The Spine Journal. 20:S91-S92
ISSN: 1529-9430
DOI: 10.1016/j.spinee.2020.05.596
Popis: BACKGROUND CONTEXT Conventional biomechanical testing methods typically utilize denuded osteoligamentous cadaveric specimens to quantify kinematic properties of the musculoskeletal system. It is postulated that circumferential paraspinal soft tissue structures provide stabilization to the lumbar and cervical spines. However, the collective effect of anterior and posterior musculature, dorsolumbar fascia, skin and posterior osseous arch on segmental flexibility of the lumbar spine has yet to be investigated. PURPOSE The purpose of the current study is to utilize novel in vitro biomechanical testing that more closely approximates the in vivo physiologic condition to quantify segmental ranges of motion at the adjacent and operative levels in multidirectional flexibility testing. STUDY DESIGN/SETTING In vitro human cadaveric model and multidirectional flexibility testing. PATIENT SAMPLE N/A OUTCOME MEASURES N/A METHODS A total of eight cadaveric spines (T9-sacrum) were utilized in this investigation. All paraspinal musculature, ligaments, dorsolumbar fascia and skin layers remained intact for initial testing followed by sequential destabilization as follows: cut skin, close skin, cut fascia, close fascia-skin, cut ligaments/facet capsules, close fascia to spinous process, laminectomy, close laminectomy, and laminectomy denuded (oteoligamentous condition). Multidirectional flexibility testing was performed at ±10Nm in flexion-extension, lateral bending, and axial rotation with range of motion quantified at the adjacent (T12-L2) and operative (L2-L5) levels. Statistical analysis included a one-way analysis of variance (ANOVA) with repeated measures and Bonferroni post hoc test. Significance was indicated at p≤0.05. RESULTS The adjacent levels indicated a significant increase in motion for the laminectomy denuded condition (144.67±20.67%) in flexion-extension (p 0.05). In axial rotation, increases in motion were observed for the laminectomy (157.95±18.27%), close laminectomy (160.54±21.39%), and laminectomy denuded (181.06±32.38%) conditions (p CONCLUSIONS The current testing methodology provides a platform to assess spinal reconstruction techniques that may employ soft tissue attachments with quantification of motion at the operative and proximal adjacent levels. Collectively, presence of the paraspinal musculature, dorsolumbar fascia, skin and osseous posterior arch influence multidirectional flexibility of the intact lumbar spine. Results emphasize the biomechanical significance of the circumferential soft tissue structures in multidirectional flexibility testing and importance of experimentally accounting for these effects in surgical destabilization and reconstruction procedures. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
Databáze: OpenAIRE
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