Biomechanical testing of anterior and posterior thoracolumbar instrumentation in the cadaveric spine. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004

Kurt M Eichholz; Patrick W Hitchon; Aaron From; Paige Rubenbauer; Satoshi Nakamura; Tae Hong Lim; James Torner

doi:10.3171/spi.2004.1.1.0116

Back

Biomechanical testing of anterior and posterior thoracolumbar instrumentation in the cadaveric spine. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004

Journal article

Peer reviewed

Biomechanical testing of anterior and posterior thoracolumbar instrumentation in the cadaveric spine. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004

Kurt M Eichholz, Patrick W Hitchon, Aaron From, Paige Rubenbauer, Satoshi Nakamura, Tae Hong Lim and James Torner

Journal of neurosurgery. Spine, Vol.1(1), pp.116-121

07/2004

DOI: 10.3171/spi.2004.1.1.0116

PMID: 15291031

View Online

Abstract

Thoracolumbar burst fractures frequently require surgical intervention. Although the use of either anterior or posterior instrumentation has advantages and disadvantages, there have been few studies in which these two approaches have been compared biomechanically. Ten human cadaveric spines were subjected to subtotal L-3 corpectomy. In five spines placement of L-3 wooden strut grafts with lateral L2-4 dual rod and screw instrumentation was performed. Five other spines underwent L1-5 pedicle screw fixation. The spines were fatigued between steps of the experiment. The spines were load tested with pure moments of 1.5, 3, 4.5, and 6 Nm in the intact state and after placement of instrumentation in six degrees of freedom (flexion, extension, right and left lateral bending, and right and left axial rotation). In axial rotation posterior instrumentation significantly increased spinal rigidity compared with that of the intact state, whereas anterior instrumentation did not. Combined anterior-posterior instrumentation did not significantly increase the rigidity of the spine when compared with anterior or posterior instrumentation alone. Posterior instrumentation alone provided a greater reduction in angular rotation compared with anterior instrumentation alone in all degrees of freedom; however, statistical significance was achieved only in extension at 6 Nm. The increased rigidity provided by pedicle screw instrumentation compared with the intact state or with anterior instrumentation is due to the longer construct spanning five levels and the three-column engagement of the pedicle screws. The decision to use anterior or posterior instrumentation should be based on the clinical necessity of canal decompression and correction of angulation.

Bone Screws

Humans

Middle Aged

Spinal Fractures - surgery

Male

Spinal Fusion

Thoracic Vertebrae - physiology

Spinal Fractures - physiopathology

Thoracic Vertebrae - surgery

Biomechanical Phenomena

Lumbar Vertebrae - surgery

Aged, 80 and over

Female

Aged

In Vitro Techniques

Cadaver

Lumbar Vertebrae - physiology

Details

Title: Subtitle: Biomechanical testing of anterior and posterior thoracolumbar instrumentation in the cadaveric spine. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004
Creators: Kurt M Eichholz - Departments of Neurosurgery, Biomedical Engineering, and Preventative Medicine and Environmental Health, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52240, USA
Patrick W Hitchon
Aaron From
Paige Rubenbauer
Satoshi Nakamura
Tae Hong Lim
James Torner
Resource Type: Journal article
Publication Details: Journal of neurosurgery. Spine, Vol.1(1), pp.116-121
DOI: 10.3171/spi.2004.1.1.0116
PMID: 15291031
NLM abbreviation: J Neurosurg Spine
ISSN: 1547-5654
eISSN: 1547-5646
Publisher: American Association of Neurological Surgeons; United States
Language: English
Date published: 07/2004
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
Record Identifier: 9983995041302771

Metrics

37 Record Views

27 Times Cited - Web of Science