Document Detail

Comparative biomechanical testing of anterior and posterior stabilization procedures.
MedLine Citation:
PMID:  15990652     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: This is a comparative in vitro biomechanical study in a calf lumbar spine model. OBJECTIVES: The objective was to compare the primary stability of an anterior instrumentation, an intercorporal cage in combination with an anterior instrumentation, and a posterior instrumentation for monosegmental spondylodesis. SUMMARY OF BACKGROUND DATA: Spondylodesis can be achieved through a posterior lumbar fusion, posterior lumbar intercorporal fusion, or an anterior lumbar intercorporal fusion. The posterior lumbar fusion is the gold standard, although the anterior approach offers some potential advantages to the transpedicular posterior techniques. METHODS: Stability testing was performed on 30 calf lumbar spine motion segments in a physiologic state (n = 30), with either an isolated anterior (MACS) or posterior instrumentation (SOCON), and with an anterior instrumentation augmented with an intercorporal cage (MACS-Cage, n = 10, respectively). Range of motion, neutral zone, and bending stiffness were measured under pure bending to 10 Nm, and bending stiffness under axial loads of up to 1500 N. RESULTS: The isolated posterior instrumentation was found to be more stable than the isolated or augmented anterior instrumentation in flexion/extension, although no significant differences were observed in lateral bending or axial rotation. The results of this biomechanical study suggest that an augmented anterior instrumentation provides similar stability for bony fusion as does the golden standard posterior instrumentation, with the exception of flexion/extension. CONCLUSION: An augmented anterior instrumentation may provide similar stability for bony fusion as does the posterior instrumentation.
Christian H Flamme; Christof Hurschler; Caroline Heymann; Nadine von der Heide
Publication Detail:
Type:  Comparative Study; In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  30     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-01     Completed Date:  2006-06-20     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E352-62     Citation Subset:  IM    
Department of Orthopaedics, Hannover Medical School, Hannover, Germany.
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MeSH Terms
Diffusion Chambers, Culture
Lumbar Vertebrae / physiology*,  surgery*
Range of Motion, Articular
Spinal Fusion / instrumentation*,  methods*
Torsion Abnormality

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