Biomechanical Analysis of Wide Posterior Releases Compared With Inferior Facetectomy and Discectomy in the Thoracolumbar and Lumbar Spine

Rynearson, Bryan; Ramanathan, Rahul; Allen, Marcus; Wang, Xiangjiang; Vaudreuil, Nicholas J.; Bell, Kevin; Bosch, Patrick

doi:10.1016/j.jspd.2018.09.004

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…In a previous study, Cheng et al ( 26 ) indicated that a posterior only release could provide a correction similar to an anterior–posterior combined approach. Rynearson et al ( 27 ) performed an in vitro biomechanical analysis and concluded a wide posterior release of the thoracolumbar spine provided significant correction. However, they did not analyze the ability of each posterior release for sagittal alignment.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of pre-contoured titanium alloy rods in inducing thoracic kyphosis after sequential spinal releases in an in vitro biomechanical model

et al. 2023

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PurposeEvaluate the ability of pre-contoured rods to induce thoracic kyphosis (TK) in human cadaveric spines and determine the effectiveness of sequential surgical adolescent idiopathic scoliosis (AIS) release procedures.MethodsSix thoracolumbar (T3-L2) spine specimens were instrumented with pedicle screws bilaterally (T4–T12). Over correction using pre-contoured rods was performed for intact condition and Cobb angle was measured. Rod radius of curvature (RoC) was measured pre- and post-reduction. The process was repeated following sequential release procedures of (1) interspinous and supraspinous ligaments (ISL); (2) ligamentum flavum; (3) Ponte osteotomy; (4) posterior longitudinal ligament (PLL); and (5) transforaminal discectomy. Cobb measurements determined the effective contribution of release on TK and RoC data displayed effects of reduction to the rods.ResultsThe intact TK (T4–12) was 38.0° and increased to 51.7° with rod reduction and over correction. Each release resulted in 5°–7°of additional kyphosis; the largest releases were ISL and PLL. All releases resulted in significant increases in kyphosis compared to intact with rod reduction and over correction. Regionally, kyphosis increased ∼2° for each region following successive releases. Comparing RoC before and after reduction showed significant 6° loss in rod curvature independent of release type.ConclusionKyphosis increased in the thoracic spine using pre-contoured and over corrected rods. Subsequent posterior releases provided a substantial, meaningful clinical change in the ability to induce additional kyphosis. Regardless of the number of releases, the ability of the rods to induce and over correct kyphosis was reduced following reduction.

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Section: Discussionmentioning

confidence: 99%

The effectiveness of pre-contoured titanium alloy rods in inducing thoracic kyphosis after sequential spinal releases in an in vitro biomechanical model

et al. 2023

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Biomechanical Model Study of the Effect of Partial Facetectomy on Lumbar Stability Under Percutaneous Endoscopy

Wen

et al. 2020

World Neurosurgery

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Pedicle Screw System May Not Control Severe Spinal Rotational Instability

Kasai

Paholpak

Nabudda

et al. 2020

Spine

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Study Design. An in vitro biomechanical study. Objective. The purpose of this study is to discuss whether pedicle screw systems can control spinal rotational instability in a functional spinal unit of lumbar spine on human cadaver. Summary of Background Data. Rotational experiments using deer lumbar cadaveric models showed that rotational range of motion (ROM) of the model fixed by a pedicle screw system with crosslinking after total facetectomy for both the sides was larger than that in the intact model, and stated that spinal rotational instability could not be controlled using a pedicle screw system. Methods. A rotation experiment using 10 functional spinal units (L3–4) of lumbar spine on human cadavers was performed by preparing the four models (intact model, damaged model, pedicle screw model, and crosslink (CL) model) in stages, then calculating and comparing rotational ROM among the four models. Results. Rotational ROM in the CL model was still larger than that of the intact model in all the samples. And, rotational ROM decreased in the order of damaged model >> pedicle screw model > CL model > intact model. Statistical analysis revealed significant differences between all models (P < 0.001). Conclusions. Pedicle screw systems may not control severe spinal rotational instability in human lumbar cadaveric models with total facetectomy on both the sides. This may represent a major biomechanical drawback to the pedicle screw system. Level of Evidence: N/A

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Biomechanical Analysis of Wide Posterior Releases Compared With Inferior Facetectomy and Discectomy in the Thoracolumbar and Lumbar Spine

Cited by 3 publications

References 25 publications

The effectiveness of pre-contoured titanium alloy rods in inducing thoracic kyphosis after sequential spinal releases in an in vitro biomechanical model

The effectiveness of pre-contoured titanium alloy rods in inducing thoracic kyphosis after sequential spinal releases in an in vitro biomechanical model

Biomechanical Model Study of the Effect of Partial Facetectomy on Lumbar Stability Under Percutaneous Endoscopy

Pedicle Screw System May Not Control Severe Spinal Rotational Instability

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