Journal article
Biomechanical rigidity of cadaveric cervical spine with posterior versus combined posterior and anterior instrumentation: Laboratory investigation
Journal of neurosurgery. Spine, Vol.10(2), pp.133-138
02/2009
DOI: 10.3171/2008.11.SPI08416
PMID: 19278327
Abstract
Object
In patients with cervical stenosis with myelopathy, posterior instrumentation following cervical laminectomy has been shown to reduce the incidence of postoperative instability and kyphosis. However, the indications for posterior plus anterior instrumentation are not always obvious, and using both posterior and anterior instrumentation routinely is unnecessary and excessive. This study examines the rigidity of the intact isolated cadaveric cervical spine, after C4–6 laminectomy, with posterior lateral mass instrumentation, and following posterior plus anterior instrumentation.
Methods
Ten fresh-frozen human cadaveric cervical spines from C-1 to T-2 were potted in the neutral position, and retroreflective markers were placed on C-3 and C-7. Specimens were mounted on a biomechanical testing frame, and angular rotations of C-3 relative to C-7 were measured. Pure moments of 0, 0.3, 0.6, 0.9, and 1.2 Nm were applied at C-2 in all 3 planes. Each specimen was load tested as follows: 1) in the intact state; 2) after C4–6 laminectomy; 3) with C3–7 lateral mass instrumentation; and 4) with C3–7 posterior plus anterior instrumentation.
Results
Laminectomy was not associated with a significant increase in motion compared with the intact state with any load or in any direction. Instrumentation was associated with reduction in motion in all directions, and there was no significant difference in posterior versus combined posterior and anterior instrumentation.
Conclusions
Rigidity imparted to the cervical spine by a 5-level posterior lateral mass fixation is not augmented by anterior instrumentation.
Details
- Title: Subtitle
- Biomechanical rigidity of cadaveric cervical spine with posterior versus combined posterior and anterior instrumentation: Laboratory investigation
- Creators
- Nader S Dahdaleh - 1Department of Neurosurgery, University of Iowa College of Medicine; andSatoshi Nakamura - 1Department of Neurosurgery, University of Iowa College of Medicine; andJames C Torner - 2Departments of Epidemiology andTae-Hong Lim - 3Biomedical Engineering, University of Iowa, Iowa City, IowaPatrick W Hitchon - 1Department of Neurosurgery, University of Iowa College of Medicine; and
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery. Spine, Vol.10(2), pp.133-138
- DOI
- 10.3171/2008.11.SPI08416
- PMID
- 19278327
- NLM abbreviation
- J Neurosurg Spine
- ISSN
- 1547-5654
- eISSN
- 1547-5646
- Publisher
- American Association of Neurological Surgeons
- Language
- English
- Date published
- 02/2009
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9983995010502771
Metrics
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