Global and segmental kinematic changes following sequential resection of posterior osteoligamentous structures in the lumbar spine: An in vitro biomechanical investigation using pure moment testing protocols
| Autor: | Ashish D. Diwan, Ashutosh B Sabnis, Uphar Chamoli, Andrei R Manolescu, Mert H Korkusuz, Naomi Tsafnat |
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| Rok vydání: | 2015 |
| Předmět: |
Macropodidae
Materials science Lumbar Vertebrae Mechanical Engineering medicine.medical_treatment General Medicine Anatomy Lumbar vertebrae Kinematics musculoskeletal system Zygapophyseal Joint Biomechanical Phenomena Couple Lumbar medicine.anatomical_structure Match moving Facetectomy Ligaments Articular medicine Animals Orthopedic Procedures Cadaveric spasm Range of motion |
| Zdroj: | Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine. 229(11) |
| ISSN: | 2041-3033 |
| Popis: | Lumbar spinal surgeries may compromise the integrity of posterior osteoligamentous structures implicating mechanical stability. Circumstances necessitating a concomitant surgery to achieve restabilisation are not well understood. The main objective of this in vitro study was to quantify global and segmental (index and adjacent levels) kinematic changes in the lumbar spine following sequential resection of the posterior osteoligamentous structures using pure moment testing protocols. Six fresh frozen cadaveric kangaroo lumbar spines (T12–S1) were tested under a bending moment in flexion–extension, bilateral bending, and axial torsion in a 6-degree-of-freedom Kinematic Spine Simulator. Specimens were tested in the following order: intact state (D0), after interspinous and supraspinous ligaments transection between L4 and L5 (D1), further after a total bilateral facetectomy between L4 and L5 (D2). Segmental motions at the cephalad, damaged, and caudal levels were recorded using an infrared-based motion tracking device. Following D1, no significant change in the global range of motion was observed in any of the bending planes. Following D2, a significant increase in the global range of motion from the baseline (D0) was observed in axial torsion (median normalised change +20%). At the damaged level, D2resulted in a significant increase in the segmental range of motion in flexion–extension (+77%) and axial torsion (+492%). Additionally, a significant decrease in the segmental range of motion in axial torsion (−35%) was observed at the caudal level following D2. These results suggest that a multi-segment lumbar spine acts as a mechanism for transmitting motions, and that a compromised joint may significantly alter motion transfer to adjacent segments. We conclude that the interspinous and supraspinous ligaments play a modest role in restricting global spinal motions within physiologic limits. Following interspinous and supraspinous ligaments transection, a total bilateral facetectomy resulted in a significant increase in axial torsion motion, both at global and damaged levels, accompanied with a compensatory decrease in motion at the caudal level. |
| Databáze: | OpenAIRE |
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