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