Position of interbody spacer in transforaminal lumbar interbody fusion: effect on 3-dimensional stability and sagittal lumbar contour
| Autor: | Wentien Wu, Chunhui Wu, Antonio Faundez, Avraam Ploumis, Amir A. Mehbod, Ensor E. Transfeldt |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
Male
Lordosis Lumbar Vertebrae/surgery Bone Screws Spinal Fusion/instrumentation/methods Lumbar Imaging Three-Dimensional Position (vector) Lumbar interbody fusion medicine Humans Orthopedics and Sports Medicine Biomechanics Aged Orthodontics Lumbar Vertebrae ddc:617 business.industry Neutral zone Lordosis/surgery Anatomy Middle Aged medicine.disease Sagittal plane Biomechanical Phenomena Spinal Fusion medicine.anatomical_structure Treatment Outcome Surgery Female Neurology (clinical) Cage Range of motion business |
| Zdroj: | Journal of Spinal Disorders and Techniques, Vol. 21, No 3 (2008) pp. 175-180 |
| ISSN: | 1536-0652 |
| Popis: | STUDY DESIGN: Biomechanical study. OBJECTIVE: To test 2 different intervertebral positions of a semilunar cage and their effects on 3-dimensional stability and segmental lordosis in a model of transforaminal lumbar interbody fusion (TLIF). SUMMARY OF BACKGROUND DATA: In his original TLIF description, Harms recommended decortication of endplates, followed by placement of mesh cages in the middle-posterior intervertebral third. Subsequent studies presented conflicting recommendations: anterior placement of the spacer-cage for better load-sharing versus placement on the stronger posterolateral endplate regions. METHODS: Six human lumbar spinal functional units were first tested intact. TLIF was performed using a semilunar poly-ether-ether-ketone cage randomly inserted in the anterior (TLIF-A) or posterior (TLIF-P) disc space. Pedicle screws and rods were added. Unconstrained pure moments in axial-torsion, lateral-bending (LB), and flexion-extension (FE) were applied under 0.05 Hz and +/-5 Nm sinusoidal waveform. Segmental motions were recorded. Range of motion (ROM) and neutral zone (NZ) were calculated. Pairwise comparisons were made using nonparametric Wilcoxon-matched pairs signed rank sum test with statistical significance set at P0.05). Delta-ROM between TLIF-A and TLIF-P was not significant (P>0.05). TLIF-A and TLIF-P significantly decreased NZ in LB (P0.05). Segmental lordosis of TLIF-A and TLIF-P on C-arm views showed angle differences within the range of measurement error of Cobb angles. CONCLUSIONS: Difference in ROM and NZ between anterior (TLIF-A) or posterior (TLIF-P) positions was not statistically significant. Similarly, both positions did not influence segmental lordosis. |
| Databáze: | OpenAIRE |
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