title: Biomechanical comparison of anterior lumbar screw-plate fixation versus posterior lumbar pedicle screw fixation.
abstract: Anterior lumbar interbody fusion (ALIF) followed by posterior pedicle screw fixation (PSF) in a second procedure is mostly used to implement lumbar spine fusion. ALIF followed by anterior lumbar screw-plate has a lot of advantages, but its biomechanical stability requires confirmation. This study evaluated the biomechanical stability of a novel anterior lumbar locked screw-plate (ALLSP) by comparison with posterior lumbar PSF. Twelve fresh human cadaveric lumbar specimens (L4-L5) were assigned to four groups: ALIF+PSF group, ALIF+ALLSP (both fixed) group, ALIF group and an untreated control (both non-fixed) group. The first three groups received implantation of a rectangular titanium cage. Tests under axial compression, flexion, extension, lateral bending, or rotation showed that the fixed groups had significantly stronger stability than the non-fixed groups (P=0.000 for all). The ALIF+ALLSP group had significantly greater axial stiffness under applied axial compression and significantly less angular displacement under rotational forces than the ALIF+PSF group. The angular displacement of the ALIF+ALLSP group was less under flexion than that of the ALIF+PSF, and the angular displacement under lateral bending and extension was greater, but these differences were not statistically significant. In summary, the ALLSP conforms to the anterior lumbar spine and has good biomechanical stability. It is a reliable choice for enhancing the stability of ALIF.
authors.affiliation: Department of Orthopedics, Southwest Hospital, Orthopedics Center of PLA, Third Military Medical University, Chongqing, 400038, China.|Department of Orthopedics, Chongqing Dongnan Hospital, Chongqing, 401336, China.
authors.forename: Lie-Hua
authors.initials: LH
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Southwest Hospital, Orthopedics Center of PLA, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Cong-Tao
authors.initials: CT
authors.lastname: Guo
authors.affiliation: Department of Orthopedics, Southwest Hospital, Orthopedics Center of PLA, Third Military Medical University, Chongqing, 400038, China. zq_tlh@163.com.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Orthopedics, Southwest Hospital, Orthopedics Center of PLA, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Xiao-Bing
authors.initials: XB
authors.lastname: Pu
authors.affiliation: Department of Orthopedics, Southwest Hospital, Orthopedics Center of PLA, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Orthopedics, Southwest Hospital, Orthopedics Center of PLA, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Hao-Ming
authors.initials: HM
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Southwest Hospital, Orthopedics Center of PLA, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of Orthopedics, Chongqing Dongnan Hospital, Chongqing, 401336, China.
authors.forename: Shi-Ming
authors.initials: SM
authors.lastname: Cheng
authors.affiliation: Department of Surgically Applied Anatomy and Surgery, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Yang-Jun
authors.initials: YJ
authors.lastname: Lan
authors.affiliation: Department of Health Statistics, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008422:Materials Testing