Enhancing the stability of anterior lumbar interbody fusion: a biomechanical comparison of anterior plate versus posterior transpedicular instrumentation

Spine
Michael N TzermiadianosA G Patwardhan

Abstract

Biomechanical study using human cadaver spines. To assess the stabilizing effect of a supplemental anterior tension band (ATB, Synthes) plate on L5-S1 anterior lumbar interbody fusion (ALIF) using a femoral ring allograft (FRA) under physiologic compressive preloads, and to compare the results with the stability achieved using FRA with supplemental transpedicular instrumentation. Posterior instrumentation can improve the stability of ALIF cages. Anterior plates have been proposed as an alternative to avoid the additional posterior approach. Eight human specimens (L3 to sacrum) were tested in the following sequence: (i) intact, (ii) after anterior insertion of an FRA at L5-S1, (iii) after instrumentation with the ATB plate, and (iv) after removal of the plate and adding transpedicular instrumentation at the same level. Specimens were tested in flexion-extension, lateral bending, and axial rotation. Flexion-extension was tested under 0 N, 400 N, and 800 N compressive follower preload to simulate physiologic compressive preloads on the lumbar spine. Stand-alone FRAs significantly decreased the range of motion (ROM) in all tested directions (P < 0.05); however, the resultant ROM was large in flexion-extension ranging between 6.1 +/...Continue Reading

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Citations

Jan 10, 2012·Computer Methods in Biomechanics and Biomedical Engineering·Zheng-Cheng ZhongChen-Sheng Chen
Dec 7, 2014·Journal of Huazhong University of Science and Technology. Medical Sciences = Hua Zhong Ke Ji Da Xue Xue Bao. Yi Xue Ying De Wen Ban = Huazhong Keji Daxue Xuebao. Yixue Yingdewen Ban·Lie-Hua LiuLing Liu
Jul 19, 2013·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Hiroyuki Yoshihara
Dec 3, 2013·The Spine Journal : Official Journal of the North American Spine Society·Dean K StolworthyAnton E Bowden
Jan 9, 2013·The Spine Journal : Official Journal of the North American Spine Society·Martin B KornblumFrank M Phillips
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Jan 1, 2012·International Journal of Spine Surgery·Daniel Kyle PalmerSerkan İnceoğlu

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