Document Detail

Biomechanical Comparison of Ponte Osteotomy and Discectomy.
MedLine Citation:
PMID:  25384049     Owner:  NLM     Status:  Publisher    
Study Design. Biomechanical cadaver studyObjective. To evaluate the relative effectiveness of Ponte osteotomies for spinal release in deformity correctionSummary of Background Data. Controversy exists as to the role of Ponte osteotomy in deformity correction surgery. Very little has been written about the biomechanical effects of Ponte osteotomy. Past biomechanical studies have been limited to application of forces through endplates, single functional units, or lack of comparison with anterior release.Methods. 12 fresh-frozen human full thoracic spinal units were tested for motion in axial rotation, flexion/extension, and lateral bending in a custom designed robotic environment. Testing was repeated after sequential facetectomy and Ponte osteotomy (6 specimens) and compared to partial and full discectomy(6 specimens).Results. Motion in axial rotation is increased 21% by Ponte osteotomy compared to 35% for full discectomy. Anterior displacement of the spinal column, creating lordosis, was increased 15% by Ponte and 40% by full discectomy. Posterior displacement of the spinal column, creating kyphosis, was increased 23% by Ponte and 89% by full discectomy. Finally, in coronal force application the Ponte osteotomy had virtually no effect (2%) compared to 40% increased motion by full discectomy.Conclusions. Posterior Ponte releases produced more motion than facetectomy alone in axial rotation and sagittal correction maneuvers, but had no effect on coronal correction. Anterior discectomy release destabilized spinal column significantly more than posterior releases in all force applications. Despite ample clinic experience demonstrating the effectiveness of posterior only surgery, the biomechanical effect of Ponte osteotomies is modest.
Cheng Wang; Kevin Bell; Michael McClincy; Lloydine Jacobs; Ozgur Dede; James Roach; Patrick Bosch
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-7
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-10     Completed Date:  -     Revised Date:  2014-11-11    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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