Prevertebral Anchored Kevlar Band to Recover Intact Spine Movement Ranges in Lumbar Disc Arthroplasty

Abstract

Anterior longitudinal ligament and annulus fibrosus removal in total disc replacement induces excessive spinal mobility with zygapophyseal joint overload and osteoarthritic changes causing chronic back pain. To control disc arthroplasty-induced hypermobility with a Kevlar® band. A 3 × 3 cm Kevlar® band implanted in twelve human lumbar cadaveric spines substituted the anterior longitudinal ligament and annulus in disc arthroplasty. Biomechanical studies compared the intact spine, after discectomy, post-disc arthroplasty, and with the Kevlar® band inserted. The Kevlar® band recovered the extension and axial rotation movement ranges without regaining the intact status. Improvement was moderate in lateral bending. The Instantaneous Axis of Rotation improved the discectomy and total disc prosthesis conditions without recovering the initial state. The disc above the operated one also showed increased mobility, particularly in extension and axial rotation, improved by Kevlar® band insertion without recovering the intact spine values. The Kevlar® band improves excess mobility ranges induced by anterior longitudinal ligament and anterior annulus removal in disc arthroplasty in the operated and supra-adjacent discs without recovering the baseline status.