Abstract:
STUDY DESIGN:An in vitro study to determine the intradiscal pressure changes during flexion in levels above a simulated fusion was performed. OBJECTIVES:To determine if intradiscal pressure increases more during flexion in discs above an instrumented spinal segment compared to an uninstrumented segment. SUMMARY OF BACKGROUND DATA:The progressive degeneration of intervertebral discs adjacent to a fused or fixed segment is a phenomenon that is noted but poorly understood. Intuitively, the degeneration appears to be a function of altered biomechanics of the motion segments in the spine. METHODS:Two intervertebral disc levels were evaluated, L3-L4 and L4-L5 from each of six fresh frozen cadaver spines. Pressure measurements were taken with the spine uninstrumented, with bilateral pedicle screw-rod instrumentation from L5 to S1, and with bilateral pedicle screw-rod instrumentation from L4 to S1. Pressure measurements were accomplished with Millar Mikro-Tip pressure transducers. The transducers were placed within the nucleus pulposus of L3-L4 and L4-L5 intervertebral discs. Pressure data were recorded by computer data acquisition. The pressure data were compared by intervertebral level and by the effects of added instrumentation. RESULTS:In general, the addition of instrumentation significantly affected the intradiscal pressure in the levels above a simulated fusion. The intradiscal pressure increased as the amount of levels involved in the simulated fusion increased. The intradiscal pressure increased as flexion motion increased. A greater increase was seen at the L4-L5 level than the L3-L4 level. When L5-S1 fixation was added, the intradiscal pressure increased. When L4-S1 fixation was added, the intradiscal pressure further increased. CONCLUSION:This study demonstrated increasing intradiscal pressures during flexion.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Weinhoffer SL,Guyer RD,Herbert M,Griffith SLdoi
10.1097/00007632-199503010-00004subject
Has Abstractpub_date
1995-03-01 00:00:00pages
526-31issue
5eissn
0362-2436issn
1528-1159journal_volume
20pub_type
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