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Biomechanical study on the effect of five different lumbar reconstruction techniques on adjacent-level intradiscal pressure and lamina strain.

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Title: Biomechanical study on the effect of five different lumbar reconstruction techniques on adjacent-level intradiscal pressure and lamina strain.
Authors: Sudo, Hideki Browse this author
Oda, Itaru Browse this author
Abumi, Kuniyoshi Browse this author
Ito, Manabu Browse this author
Kotani, Yoshihisa Browse this author
Minami, Akio Browse this author →KAKEN DB
Keywords: biomechanical testing
lumbar spine
posterior lumbar interbody fusion
intradiscal pressure
lamina strain
kyphosis
Issue Date: Aug-2006
Publisher: American Association of Neurological Surgeons
Journal Title: Journal Of Neurosurgery:Spine
Volume: 5
Issue: 2
Start Page: 150
End Page: 155
PMID: 16925082
Abstract: OBJECT: The objectives of this study were to compare the biomechanical effects of five lumbar reconstruction models on the adjacent segment and to analyze the effects of three factors: construct stiffness, sagittal alignment, and the number of fused segments. METHODS: Nondestructive flexion-extension tests were performed by applying pure moments to 10 calf spinal (L3-S1) specimens. One-segment (L5-6) or two-segment (L5-S1) posterior fusion methods were simulated: 1) one-segment posterolateral fusion (PLF); 2) one-segment PLF with interbody fusion cages (one-segment PLIF/PLF); 3) two-segment PLF; 4) two-segment PLIF/PLF; and 5) two-segment PLF in kyphosis (two-segment kyphotic PLF). The range of motion (ROM) of the reconstructed segments, intradiscal pressure (IDP), and lamina strain in the upper (L4-5) adjacent segment were analyzed. The ROM was significantly decreased in the PLIF/PLF models compared with that in the PLF alone models after both the one- and two-segment fusions. If the number of fused segments was increased, the pressure and strains were also increased in specimens subjected to the PLIF/PLF procedure, more so than the PLF-alone procedure. In the one-segment PLIF/PLF model the authors observed a reduced IDP and lamina strain compared with those in the kyphotic two-segment PLF model despite the latter's higher levels of initial stiffness. CONCLUSIONS: If the number of fused levels can be reduced by using PLIF to correct local kyphosis, then this procedure may be valuable for reducing adjacent-segment degenerative changes.
Rights: The final version of the paper was published in Journal Of Neurosurgery:Spine, 2006, volume5-2. For reuse of any of the materials, including editorial copy, figures, or tables please contact the Journal of Neurosurgery at jneuro@virginia.edu
Type: article (author version)
URI: http://hdl.handle.net/2115/14612
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 須藤 英毅

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