Unilateral laminoplasty with lateral mass screw fixation for less invasive decompression of the cervical spine: a biomechanical investigation
| Autor: | Luca Papavero, C. Schilling, T. M. Grupp, Klaus Püschel, Ralph Kothe, Gregor Schmeiser |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Rotation Decompression medicine.medical_treatment Bone Screws Spinal Cord Diseases Laminoplasty Spinal Osteophytosis Cadaver medicine Humans Orthopedics and Sports Medicine Range of Motion Articular Pliability Aged Aged 80 and over business.industry Neutral zone Biomechanics Laminectomy Middle Aged Decompression Surgical Surgery Biomechanical Phenomena medicine.anatomical_structure Cervical Vertebrae Female Spondylosis Range of motion Nuclear medicine business Cervical vertebrae |
| Zdroj: | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 24(12) |
| ISSN: | 1432-0932 |
| Popis: | To compare the stabilization behavior of additional unilateral mass screw fixation with current standard procedures in patients with cervical spondylotic myelopathy (CSM) in a biomechanical study.Ten human C2-C7 cervical specimens were tested under various segment conditions: native (NAT), laminoplasty (LP), laminoplasty with unilateral (LPU) or bilateral (LPB) stabilization, laminectomy with bilateral stabilization (LCB), and laminectomy. The instrumented level was from C3 to C6. For each segment condition, in vitro flexibility tests were performed using a spinal simulator and an applied load of ±2.5 Nm. The three-dimensional kinematics of the entire cervical segment in three main loading directions [flexion-extension (FE), lateral bending (LB), and axial rotation (AR)] was measured with an ultrasonic motion analysis system. Analysis of variance followed by a post hoc test was used to determine differences under the specific segment conditions to assess the parameters range of motion (ROM) and neutral zone (NZ).For FE, the total ROM of laminoplasty (-6.3% difference to NAT) and laminectomy (+6.4%) remained at the level of native (p0.56), whereas the instrumentations LPU (-37.1%), LPB (-44%), and LCB (-43.2%) lead to significant reductions (p0.01) without significant differences in LPU to LPB and LCB (p0.38). The same results were found with LB. For AR, the stabilization of all instrumentations was less pronounced, but had the same tendency seen for FE and AR. The results for the NZ showed equivalent values as that for ROM.The degree of stabilization was as expected for LC and LCB; namely, no stabilization for LC and maximal stabilization for LCB. LPU exhibited almost the same degree of stabilization as LCB. LPU could be a new treatment option for less invasive decompression for multilevel CSM. |
| Databáze: | OpenAIRE |
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