Effect of cage design, supplemental posterior instrumentation and approach on primary stability of a lumbar interbody fusion – A biomechanical in vitro study
There are various techniques and approaches for lumbar interbody fusion differing in access, cage type and type of supplemental posterior instrumentation. While a transforaminal access usually includes a hemifacetectomy, the facet joint can be preserved with a more lateral extraforaminal access. The...
Gespeichert in:
Veröffentlicht in: | Clinical biomechanics (Bristol) 2017-10, Vol.48, p.30-34 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
Zusammenfassung: | There are various techniques and approaches for lumbar interbody fusion differing in access, cage type and type of supplemental posterior instrumentation. While a transforaminal access usually includes a hemifacetectomy, the facet joint can be preserved with a more lateral extraforaminal access. The supplemental posterior instrumentation required for both fusion techniques is still debated. The purpose of the present study was to compare primary stability of the two accesses for two different cage types with none, unilateral and bilateral supplemental posterior instrumentation.
Six monosegmental lumbar functional spinal units (FSUs) were included in each of the two groups, and subjected to a flexibility test. As cages, a newly designed cage was compared to a standard cage in the following states: (a) native, (b) stand-alone cage, (c) bilateral internal fixator, (d) unilateral internal fixator, (e) unilateral facetectomy+bilateral internal fixator, (f) unilateral facetectomy+unilateral internal fixator and (g) unilateral facetectomy with stand-alone cage. For comparison the range of motion was normalized to the native state and the effects of the facetectomy, cage type, and supplemental instrumentation was compared.
Within the subject comparison showed a significantly higher flexibility for the unilateral facetectomy in all motion directions (punilateral fixator>bilateral fixator).
Cage design and approach type are affecting the primary stability of lumbar interbody fusion procedures while the type of posterior instrumentation is the most influencing factor.
•Cage design has an effect on primary stability in lumbar fusion procedures.•Preserving the facet joint increases primary stability.•Type of posterior instrumentation has most dominant effect on primary stability. |
---|---|
ISSN: | 0268-0033 1879-1271 |
DOI: | 10.1016/j.clinbiomech.2017.07.007 |