In vitro biomechanical studies of an anterior thoracolumbar implant.
After L1 corpectomy in T11-L3 human cadaveric spine, anterior thoracolumbar instrumentation with strut grafting restores spinal stability. T12-L2 angular rotation was measured in response to moments of 0.0, 1.5, 3.0, 4.5, and 6.0 Nm in flexion, extension, lateral bending, and axial rotation, respectively. The spines were tested: 1) intact; 2) after partial L1 corpectomy, grafting, and instrumentation (Profile plate, DePuy-AcroMed, Raynham, MA), with the wooden dowel graft screwed to the plate; 3) without graft screw fixation; and 4) after flexion-extension cyclic fatiguing for 5000 cycles at a load of +/-3.0 Nm. Before and after fatiguing, the instrumented spine was significantly (p <or= 0.05) stiffer than the intact spine in flexion, extension, and right and left lateral bending but not in axial rotation. There were no significant differences between the constructs with or without graft-to-plate fixation before or after fatigue. The instrumented spines were more rigid in bending away from the implant than bending toward the implant. Anterior spinal instrumentation with the Profile implant augments stiffness in the sagittal and coronal planes but not in the axial plane. Although graft-to-plate fixation may prevent graft migration into the canal, it does not contribute to spinal rigidity.
Hitchon
Patrick W
PW
Department of Neurosurgery, University of Iowa, Iowa City, USA. patrick-hitchon@uiowa.edu
Brenton
Matthew D
MD
Serhan
Hassan
H
Goel
Vijay K
VK
Torner
James C
JC
D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D016268:Internal Fixators; D007593:Joint Instability / Q000601:surgery*; D007595:Joint Prosthesis; D008159:Lumbar Vertebrae / Q000601:surgery*; D016059:Range of Motion, Articular; D012399:Rotation; D013314:Stress, Mechanical; D013904:Thoracic Vertebrae / Q000601:surgery*