In vitro biomechanical comparison of an anterior and anterolateral lumbar plate with posterior fixation following single-level anterior lumbar interbody fusion

Johnson, Wesley M.; Nichols, Tann A.; Jethwani, Deepika; Guiot, Bernard H.

doi:10.3171/spi-07/09/332

Cited by 16 publications

(18 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, an anterior plate or posterior instrumentation following anterior lumbar interbody fusion has been shown as biomechanically stable regardless of the plate location [8]. Also corrective PSO can give the ability of soft tissue coverage of instrumentation by increasing lordosis, which is not acceptable in the present case for the severely damaged soft tissue at the posterior kyphotic site.…”

Section: Discussionmentioning

confidence: 93%

Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis

Yamazaki

Orita

Sainoh

et al. 2013

Case Reports in Orthopedics

View full text Add to dashboard Cite

A 26-year-old paraplegic schizophrenic Japanese woman suffered from severe kyphosis and back pain derived from lumbar burst fractures caused by jumping. She had already undergone resection of the L1 and L2 spinous processes for sharp angular kyphosis, but she still had severe kyphosis and back pain at the L1 and L2. Radiographical examination revealed fused anterior columns at L1 and L2 with severe local kyphosis and a significantly decreased percutaneous distance in the back. The patient underwent anterior instrumented bony resection including an L2 vertebral osteotomy: bilateral L2-L3 facetectomy and partial posterior osteotomy of the L2 vertebrae via a posterior approach followed by an anterior corpectomy of the L2 vertebrae and insertion of a cylindrical cage. No posterior instrumentation was used owing to the presence of atrophied paraspinal soft tissues. Lumbar interbody fusion was performed with vertebral body screws extending from T12 to L4 and corresponding anterior distension and posterior compression. The procedure corrected the kyphosis by 15° and enhanced local stability. Postsurgical visual analogue scale improved from 9.0 to 2.0 and Oswestry Disability Index from 40 to 17.8, respectively. In conclusion, we have demonstrated that anterolateral interbody fusion using extended fixation can compensate for posterior corrective surgery.

show abstract

Section: Discussionmentioning

confidence: 93%

Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis

Yamazaki

Orita

Sainoh

et al. 2013

Case Reports in Orthopedics

View full text Add to dashboard Cite

show abstract

“…They also considered posterior PSF the biomechanical gold standard for enhancing the stability of ALIF cages. Johnson et al [15] combined ALIF with either an anterior Unity LX plate (Blackstone Medical Inc., USA), an anterolateral Unity LX plate, or PSF, and found no significant difference in range of motion among them in terms of flexion and extension, lateral bending, or axial torsion. The biomechanical stabilities of both the lateral and anterior fixations were no better than those of the posterior PSF.…”

Section: Discussionmentioning

confidence: 97%

“…Biomechanical testing is an effective method for evaluation of stability [12][13][14] . It has been reported that posterior PSF is no less biomechanically stable than either the anterior tension band plate (Synthes) [5] used in anterior L1-S1 fixation, or the Unity LX plates (Blackstone Medical, USA) [15] for the inferior lumbar spine. Gerber et al [16] designed a triangular three-hole screw-plate that was approved by the Food and Drug Administration of USA for supplemental fixation between the iliac vessels at L5-S1.…”

mentioning

confidence: 99%

Biomechanical comparison of anterior lumbar screw-plate fixation versus posterior lumbar pedicle screw fixation

Liu

Guo

Zhou

et al. 2014

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

View full text Add to dashboard Cite

Anterior lumbar interbody fusion (ALIF) followed by posterior pedicle screw fixation (PSF) in a second procedure is mostly used to implement lumbar spine fusion. ALIF followed by anterior lumbar screw-plate has a lot of advantages, but its biomechanical stability requires confirmation. This study evaluated the biomechanical stability of a novel anterior lumbar locked screw-plate (ALLSP) by comparison with posterior lumbar PSF. Twelve fresh human cadaveric lumbar specimens (L4-L5) were assigned to four groups: ALIF+PSF group, ALIF+ALLSP (both fixed) group, ALIF group and an untreated control (both non-fixed) group. The first three groups received implantation of a rectangular titanium cage. Tests under axial compression, flexion, extension, lateral bending, or rotation showed that the fixed groups had significantly stronger stability than the non-fixed groups (P=0.000 for all). The ALIF+ALLSP group had significantly greater axial stiffness under applied axial compression and significantly less angular displacement under rotational forces than the ALIF+PSF group. The angular displacement of the ALIF+ALLSP group was less under flexion than that of the ALIF+PSF, and the angular displacement under lateral bending and extension was greater, but these differences were not statistically significant. In summary, the ALLSP conforms to the anterior lumbar spine and has good biomechanical stability. It is a reliable choice for enhancing the stability of ALIF.

show abstract

“…Although internal fixation of the spine is an established practice, much is not known about the effects that various design factors have on the performance of instrumentation employed [1][2][3]. Considerable work exists concerning screw pullout forces [1,4,5] and plate/screw constructs for anterior fusion of the cervical spine [2,[6][7][8], but less work exists examining these issues for the lumbar spine.…”

Section: Introductionmentioning

confidence: 99%

“…However, the fixation strength of these cages in an overtly unstable spine usually requires the assistance of either anterior or posterior instrumentation for additional support [13][14][15][16]. Although there are studies comparing anterior lumbar plates to posterior instrumentation [3,14,16], biomechanical comparisons of fixed verses variable angle lumbar plate constructs remain lacking from the literature.…”

Section: Introductionmentioning

confidence: 99%

Pullout Strength Of Anterior Lumbar Interbody Fusion Plates: Fixed Versus Variable Angle Screw Designs

Hadley¹

2013

J Spine

View full text Add to dashboard Cite

Purpose: To compare the pullout loads of variable versus fixed angle screws in anterior lumbar interbody fusion (ALIF) plate/screw constructs in both foam and cadaveric models. Methods: An ALIF plate was secured to a 0.160 g/cm 3 polyurethane foam block (N = 10) with fixed or equivalentlypositioned variable angle screws and pulled out at 1 mm/min to failure. Embalmed human vertebral pairs (N = 10) were similarly utilized to compare fixed versus variable angle plate/screw constructs for pullout strength. Results: There was no statistically significant difference between fixed and variable angle plates for either foam (p = 0.6) or vertebral specimens (p = 0.3) based on maximum load or stiffness. The maximum load for the vertebral specimens was on average 39% of that for the foam (p = 0.001) and the stiffness was about 55% of that for the foam (p = 0.001). Conclusions: In this study, no statistically significant difference in pullout strength or stiffness was found between fixed and variable angle ALIF plate/screw constructs. However, the embalmed cadaveric bone model was shown to be statistically weaker in pullout strength and stiffness when compared to the foam model. This study suggests that the foam model may not always be representative of the cadaveric model in the magnitude of load, but may still provide good comparative results between different designs.

show abstract

In vitro biomechanical comparison of an anterior and anterolateral lumbar plate with posterior fixation following single-level anterior lumbar interbody fusion

Cited by 16 publications

References 24 publications

Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis

Anterolateral Corrective Lumbar Corpectomy and Interbody Fusion by Using Extended Screw Fixation without Posterior Instrumentation for Posttraumatic Kyphosis

Biomechanical comparison of anterior lumbar screw-plate fixation versus posterior lumbar pedicle screw fixation

Pullout Strength Of Anterior Lumbar Interbody Fusion Plates: Fixed Versus Variable Angle Screw Designs

Contact Info

Product

Resources

About