Elastic stabilization alone or combined with rigid fusion in spinal surgery: a biomechanical study and clinical experience based on 82 cases.
The authors report their experience with the treatment of lumbar instability by a kind of spine stabilization. The elastic stabilization, which follows a new philosophy, is obtained by an interspinous device, and should be used alone in degenerative disc disease, recurrent disc herniation and in very low grade instability, or in association with rigid fusion for the prevention of pathology of the border area. In collaboration with bioengineers, we carried out an experimental study on a lumbar spine model in order to calculate stresses and deformations of lumbar disc during simulation of motion, in physiological conditions and when elastic stabilization is combined with rigid fusion. Results suggest that elastic stabilization reduces stresses on the adjacent disc up to 28 degrees of flexion. Based on this preliminary result, we began to use elastic stabilization alone or combined with fusion in 1994. To date, we have performed 82 surgical procedures, 57 using stabilization alone and 25 combined with fusion, in patients affected by degenerative disc disease, disc herniation, recurrence of disc herniation or other pathologies. Clinical results are satisfactory, especially in the group of patients affected by recurrent disc herniation, in whom the elastic device was used alone.
Caserta
S
S
Spine Division, Gaetano Pini Orthopaedic Institute, Piazza Cardinale Andrea Ferrari no 1, 20122 Milan, Italy. caserta@g-pini.unimi.it
La Maida
G A
GA
Misaggi
B
B
Peroni
D
D
Pietrabissa
R
R
Raimondi
M T
MT
Redaelli
A
A
D000328:Adult; D001696:Biomechanical Phenomena; D003198:Computer Simulation; D004548:Elasticity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000502:physiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D016059:Range of Motion, Articular; D013123:Spinal Fusion / Q000379:methods*; D013130:Spinal Stenosis / Q000601:surgery*; D013168:Spondylolisthesis / Q000601:surgery*; D016896:Treatment Outcome