Abstract:
STUDY DESIGN:A biomechanical calf cadaver study. OBJECTIVE:The purpose of this study was to determine the intradiscal pressure gradient of bridged healthy intervertebral segments in correlation with intraoperative distraction force. SUMMARY OF BACKGROUND DATA:Bisegmental dorsal stabilization and anatomic reduction is a common treatment option for incomplete burst fractures of the lumbar spine. However, it remains unknown to what extent bridging and intraoperative distraction compromises an intact intervertebral disc. METHODS:The L2-L3 intervertebral disc level was evaluated in 6 freshly frozen calf cadaver spines. Pressure measurements were obtained with the spine uninstrumented, after dorsal segmental instrumentation from L1 to L3, and after distraction with 400 N and 800 N. Pressure gradient measurements were accomplished with a balloon pressure sensor placed within the nucleus pulposus of the L2-L3 intervertebral disc. Pressure data were recorded by computer data acquisition. Flexion, extension, and lateral bending moments were applied continuously by a testing machine up to a load moment of 7.5 N·m. The pressure gradients were compared with respect to the effects of added instrumentation and distraction. RESULTS:After segmental bridging the mean pressure gradients were significantly reduced in all movement directions (P < 0.001). However, after dorsal stabilization a continuously rising intervertebral disc pressure was recordable. In contrast, no relevant additional reduction of the intradiscal pressure gradient was detectable after applying distraction forces of 400 N or 800 N. CONCLUSION:In a calf model, a distraction force of up to 800 N leads to no additional reduction of the pressure gradient of bridged healthy lumbar segments under flexion and extension moments.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Spiegl U,Pätzold R,Glasmacher S,Stephan D,Josten C,Bühren V,Gonschorek O,Augat Pdoi
10.1097/BRS.0000000000000213subject
Has Abstractpub_date
2014-04-01 00:00:00pages
E427-33issue
7eissn
0362-2436issn
1528-1159journal_volume
39pub_type
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