Sacral spinous processes: a morphologic classification and biomechanical characterization of strength

The Spine Journal : Official Journal of the North American Spine Society
Tim WangTodd Alamin

Abstract

There has been increasing interest in using the lumbosacral spinous processes for fixation as a less invasive alternative to transpedicular instrumentation. Alhough prior studies have described the appearance and biomechanics of lumbar spinous processes, few have evaluated the dimensions, morphology, or strength of the sacral spinous processes. The goals of this study were to characterize the morphology of the S1 spinous process and biomechanical strength of the S1 spinous process when loaded in a cranial direction. This study was performed as both an analysis of radiographic data and biomechanical testing of cadaveric specimens. Lumbosacral spine radiographs and computed tomography scans of 20 patients were evaluated for visibility and morphology of the S1 spinous process. S1 spinous process length, height, and size of the L5-S1 segment were measured. Additionally, 13 cadaveric lumbosacral spinal segments were obtained for biomechanical testing and morphologic analysis. Specimens were loaded at the S1 spinous process in a cranial direction via a strap, simulating resistance to a flexion moment applied across the L5-S1 segment. Peak load to failure, displacement, and mode of failure were recorded. The S1 spinous process was cle...Continue Reading

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