Kinematic efficacy of supplemental anterior lumbar interbody fusion at lumbosacral levels in thoracolumbosacral deformity correction with and without pedicle subtraction osteotomy at L3: an in vitro cadaveric study

Object The aim of this study was to determine the in vitro biomechanical responses of lumbar spinal segments after implantation of tapered cages. Methods Range of motion (ROM)– and stiffness-related data were determined in 10 human cadaveric T12–S1 columns subjected to flexion, extension, and lateral bending modes before and after anterior lumbar interbody fusion in which stand-alone LT-CAGE devices were used. The overall column showed no significant changes in ROM or stiffness. At the instrumented level, stiffness increased significantly (p < 0.05) in flexion and lateral bending modes. Indications of instability in extension were present, but these values were not statistically significant. There was no evidence of adjacent-level instability at any level in any mode, except for the segment superior to the fixation level in flexion; here there was a significant increase in ROM (p < 0.05) and a decrease in stiffness. Conclusions The anatomical conformity and bilateral placement of cages provide ample stability and rigidity at the treated level, comparable to that of other cage systems. Because hypermobility is traditionally related to early degenerative changes, the present results appear to suggest that cages do not significantly contribute to such alterations.

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In Vitro, Biomechanical Comparison of an Anterior Lumbar Interbody Fusion with an Anteriorly Placed, Low-Profile Lumbar Plate and Posteriorly Placed Pedicle Screws or Translaminar Screws

Spine ◽

10.1097/01.brs.0000174275.95104.12 ◽

2005 ◽

Vol 30 (16) ◽

pp. 1846-1851 ◽

Cited By ~ 58

Author(s):

Brian P. Beaubien ◽

Alihan Derincek ◽

William D. Lew ◽

Kirkham B. Wood

Keyword(s):

Interbody Fusion ◽

Pedicle Screws ◽

Anterior Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion ◽

Low Profile ◽

Translaminar Screws ◽

Biomechanical Comparison

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Revision of transforaminal lumbar interbody fusion using anterior lumbar interbody fusion: a biomechanical study in nonosteoporotic bone

Journal of Neurosurgery Spine ◽

10.3171/2009.7.spine0921 ◽

2010 ◽

Vol 12 (1) ◽

pp. 82-87 ◽

Cited By ~ 5

Author(s):

Avraam Ploumis ◽

Chunhui Wu ◽

Amir Mehbod ◽

Gustav Fischer ◽

Antonio Faundez ◽

...

Keyword(s):

Interbody Fusion ◽

Posterior Instrumentation ◽

Transforaminal Lumbar Interbody Fusion ◽

Anterior Lumbar Interbody Fusion ◽

Posterior Fixation ◽

Lumbar Interbody Fusion ◽

Mineral Density ◽

Normal Bone Mineral Density ◽

Flexion Extension

Object Transforaminal lumbar interbody fusion (TLIF) is a popular fusion technique for treating chronic low-back pain. In cases of interbody nonfusion, revision techniques for TLIF include anterior lumbar interbody fusion (ALIF) approaches. Biomechanical data of the revision techniques are not available. The purpose of this study was to compare the immediate construct stability, in terms of range of motion (ROM) and neutral zone (NZ), of a revision ALIF procedure for an unsuccessful TLIF. An in vitro biomechanical comparison of TLIF and its ALIF revision procedure was conducted on cadaveric nonosteoporotic human spine segments. Methods Twelve cadaveric lumbar motion segments with normal bone mineral density were loaded in unconstrained axial torsion, lateral bending, and flexion-extension under 0.05 Hz and ± 6-nm sinusoidal waveform. The specimens underwent TLIF (with posterior pedicle fixation) and anterior ALIF (with intact posterior fixation). Multidirectional flexibility testing was conducted following each step. The ROM and NZ data were measured and calculated for each test. Results Globally, the TLIF and revision ALIF procedures significantly reduced ROM and NZ compared with that of the intact condition. The revision ALIF procedures achieved similar ROM as the TLIF procedure. Conclusions Revision ALIF maintained biomechanical stability of TLIF in nonosteoporotic spines. Revision ALIF can be performed without sacrificing spinal stability in cases of intact posterior instrumentation.

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