Augmentation of an anterior lumbar interbody fusion with an anterior plate or pedicle screw fixation: a comparative biomechanical in vitro study

被引:15
|
作者
Nichols, Tann A.
Yantzer, Brenda K.
Alameda, Suzanne
Johnson, Wesley M.
Guiot, Bernard H.
机构
[1] Univ S Florida, Dept Neurol Surg, Spine Biomech Lab, Tampa, FL USA
[2] Univ S Florida, Biomech Engn Program, Tampa, FL USA
关键词
anterior interbody lumbar fusion; plate; pedicle screw; biomechanics; cadaver;
D O I
10.3171/spi.2007.6.3.267
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Object. Posterior pedicle screw (PS) instrumentation is often used to augment anterior lumbar interbody fusion (ALIF) but at the cost of an increase in the morbidity rate due to the second approach and screw placement. If anterior plates were found to be biomechanically equivalent to PS fixation (PSF) after ALIF, then this second approach could be avoided without decreasing vertebral stability. Methods. Eight cadaveric L5-S1 spinal segments were tested under four conditions: intact, following anterior discectomy and interbody spacer placement, after placement of an anterior plate, and following PSF. The elastic zone and stiffness were calculated for axial compression, flexion/extension, lateral bending, and torsion. Neither anterior plate stabilization nor PSF showed significant intergroup differences in stiffness or the elastic zone. Both exhibited greater stiffness in flexion than the intact specimens (p < 0.001). Pedicle screw fixation was associated with a decreased elastic zone in lateral bending compared with the intact specimen (p < 0.04). Conclusions. Anterior plate fixation is biomechanically similar to PSF following ALIF. Surgeons may wish to use anterior plates in place of PSs to avoid the need for a posterior procedure. This may lead to a decrease in operative morbidity and improved overall outcomes.
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页码:267 / 271
页数:5
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