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The Influence of Distraction Force on the Intradiscal Pressure Gradient in the Bridged Lumbar Spine: A Biomechanical Investigation Using a Calf Model.
MedLine Citation:
PMID:  24480960     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Study Design. A biomechanical study calf cadaver studyObjective. The purpose of this study was to determine the intradiscal pressure gradient of bridged healthy intervertebral segments in correlation with intraoperative distraction force.Summary of Background Data. Bisegmental dorsal stabilization and anatomic reduction is a common treatment option for incomplete burst fractures of the lumbar spine. However, it remains unknown to what extent bridging and intraoperative distraction compromises an intact intervertebral disc.Methods. The L2-3 intervertebral disc level was evaluated in six fresh frozen calf cadaver spines. Pressure measurements were taken with the spine uninstrumented, after dorsal segmental instrumentation from L1 to L3, and after distraction with 400 N and 800 N. Pressure gradient measurements were accomplished with a balloon pressure sensor placed within the nucleus pulposus of the L2-L3 intervertebral disc. Pressure data were recorded by computer data acquisition. Flexion, extension, and lateral bending moments were applied continuously by a testing machine up to a load moment of 7.5 Nm. The pressure gradients were compared with respect to the effects of added instrumentation and distraction.Results. After segmental bridging the mean pressure gradients were significantly reduced in all movement directions (p < 0.001). However, after dorsal stabilization a continuously rising intervertebral disc pressure was recordable. In contrast, no relevant additional reduction of the intradiscal pressure gradient was detectable after applying distraction forces of 400N or 800N.Conclusions. In a calf model, a distraction force of up to 800N leads to no additional reduction of the pressure gradient of bridged healthy lumbar segments under flexion and extension moments.
Authors:
U Spiegl; R Pätzold; S Glasmacher; D Stephan; C Josten; V Bühren; O Gonschorek; P Augat
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-1-29
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2014-1-31     Completed Date:  -     Revised Date:  -    
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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