Biomechanical effects of laminectomy on thoracic spine stability.

Abstract:

:Thoracic columns (T1-L1 levels) from 15 fresh human cadavers were used to quantify alterations in the biomechanical response after laminectomy. Eight specimens were tested intact (Group I); the remaining seven preparations were tested after two-level laminectomy (Group II) at the midheight of the column. All specimens were fixed at the proximal and distal ends and loaded until failure. Force and deformation were collected by use of a data acquisition system. Failure of the Group I specimens included compressive fractures with or without posterior element distractions, generally at the midheight of the column. Group II preparations failed at the superior aspect of laminectomy or at a level above laminectomy, suggesting an increased load sharing. Biomechanical responses of the Group II preparations were significantly different (P < 0.05) from those of the Group I specimens at deformations from the physiological to the failure range. In addition, failure forces for Group II preparations were significantly lower (P < 0.001) than for Group I specimens. The stiffness and energy-absorbing capacities of the laminectomized specimens were also significantly different (P < 0.05) from those of the intact columns. In contrast, the deflections at failure for the two groups were not statistically different, suggesting that the human thoracic spine is deformation sensitive. Our data demonstrate that a two-level laminectomy decreases the strength and stability of the thoracic spine throughout the loading range. Although this is not a practical concern with an otherwise intact vertebral column, laminectomy, when other abnormalities such as vertebral fracture, tumor, or infection exist, may require stabilization by fusion and instrumentation.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Yoganandan N,Maiman DJ,Pintar FA,Bennett GJ,Larson SJ

doi

10.1227/00006123-199304000-00017

subject

Has Abstract

pub_date

1993-04-01 00:00:00

pages

604-10

issue

4

eissn

0148-396X

issn

1524-4040

journal_volume

32

pub_type

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