Biomechanical analysis of anterior versus posterior instrumentation following a thoracolumbar corpectomy: Laboratory investigation

Stephanus V Viljoen; Nicole A DeVries Watson; Nicole M Grosland; James Torner; Brian Dalm; Patrick W Hitchon

doi:10.3171/2014.6.SPINE13751

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Biomechanical analysis of anterior versus posterior instrumentation following a thoracolumbar corpectomy: Laboratory investigation

Journal article

Peer reviewed

Biomechanical analysis of anterior versus posterior instrumentation following a thoracolumbar corpectomy: Laboratory investigation

Stephanus V Viljoen, Nicole A DeVries Watson, Nicole M Grosland, James Torner, Brian Dalm and Patrick W Hitchon

Journal of neurosurgery. Spine, Vol.21(4), pp.577-581

10/2014

DOI: 10.3171/2014.6.SPINE13751

PMID: 25084029

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Abstract

The objective of this study was to evaluate the biomechanical properties of lateral instrumentation compared with short- and long-segment pedicle screw constructs following an L-1 corpectomy and reconstruction with an expandable cage. Eight human cadaveric T10-L4 spines underwent an L-1 corpectomy followed by placement of an expandable cage. The spines then underwent placement of lateral instrumentation consisting of 4 monoaxial screws and 2 rods with 2 cross-connectors, short-segment pedicle screw fixation involving 1 level above and below the corpectomy, and long-segment pedicle screw fixation (2 levels above and below). The order of instrumentation was randomized in the 8 specimens. Testing was conducted for each fixation technique. The spines were tested with a pure moment of 6 Nm in all 6 degrees of freedom (flexion, extension, right and left lateral bending, and right and left axial rotation). In flexion, extension, and left/right lateral bending, posterior long-segment instrumentation had significantly less motion compared with the intact state. Additionally, posterior long-segment instrumentation was significantly more rigid than short-segment and lateral instrumentation in flexion, extension, and left/right lateral bending. In axial rotation, the posterior long-segment construct as well as lateral instrumentation were not significantly more rigid than the intact state. The posterior long-segment construct was the most rigid in all 6 degrees of freedom. In the setting of highly unstable fractures requiring anterior reconstruction, and involving all 3 columns, long-segment posterior pedicle screw constructs are the most rigid.

Thoracic Vertebrae - surgery

Biomechanical Phenomena

Lumbar Vertebrae - surgery

Bone Screws

Humans

Aged, 80 and over

Stress, Mechanical

Female

Male

Rotation

Cadaver

Spinal Fusion - instrumentation

Details

Title: Subtitle: Biomechanical analysis of anterior versus posterior instrumentation following a thoracolumbar corpectomy: Laboratory investigation
Creators: Stephanus V Viljoen - Departments of 1 Neurosurgery
Nicole A DeVries Watson
Nicole M Grosland
James Torner
Brian Dalm
Patrick W Hitchon
Resource Type: Journal article
Publication Details: Journal of neurosurgery. Spine, Vol.21(4), pp.577-581
DOI: 10.3171/2014.6.SPINE13751
PMID: 25084029
NLM abbreviation: J Neurosurg Spine
ISSN: 1547-5654
eISSN: 1547-5646
Publisher: American Association of Neurological Surgeons; United States
Language: English
Date published: 10/2014
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Iowa Technology Institute; Epidemiology; Orthopedics and Rehabilitation; Surgery; Injury Prevention Research Center; Neurosurgery
Record Identifier: 9983995136202771

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