Abstract
Study Design: Ex vivo human cadaveric study.
Objective: The development or progression of adjacent segment disease (ASD) after spine stabilization and fusion is a major problem in spine surgery. Apart from optimal balancing of the sagittal profile, dynamic instrumentation is often suggested to prevent or impede ASD. Hybrid instrumentation is used to gain stabilization while allowing motion to avoid hypermobility in the adjacent segment. In this biomechanical study, the effects of two different hybrid instrumentations on human cadaver spines were evaluated and compared with a rigid instrumentation.
Methods: Eighteen human cadaver spines (T11-L5) were subdivided into three groups: rigid, dynamic, and hook comprising six spines each. Clinical parameters and initial mechanical characteristics were consistent among groups. All specimens received rigid fixation from L3-L5 followed by application of a free bending load of extension and flexion. The range of motion (ROM) for every segment was evaluated. For the rigid group, further rigid fixation from L1-L5 was applied. A dynamic Elaspine system (Spinelab AG, Winterthur, Switzerland) was applied from L1 to L3 for the dynamic group, and the hook group was instrumented with additional laminar hooks at L1-L3. ROM was then evaluated again.
Results: There was no significant difference in ROM among the three instrumentation techniques.
Conclusion: Based on this data, the intended advantage of a hybrid or dynamic instrumentation might not be achieved.
| Original language | English |
|---|---|
| Pages (from-to) | 47-53 |
| Number of pages | 7 |
| Journal | Global Spine Journal |
| Volume | 7 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Feb 2017 |
| Externally published | Yes |
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Hybrid Instrumentation in Lumbar Spinal Fusion : A Biomechanical Evaluation of Three Different Instrumentation Techniques. / Obid, Peter; Danyali, Reza; Kueny, Rebecca; Huber, Gerd; Reichl, Michael; Richter, Alexander; Niemeyer, Thomas; Morlock, Michael; Püschel, Klaus; Übeyli, Hüseyin.
In: Global Spine Journal, Vol. 7, No. 1, 01.02.2017, p. 47-53.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Hybrid Instrumentation in Lumbar Spinal Fusion
T2 - A Biomechanical Evaluation of Three Different Instrumentation Techniques
AU - Obid, Peter
AU - Danyali, Reza
AU - Kueny, Rebecca
AU - Huber, Gerd
AU - Reichl, Michael
AU - Richter, Alexander
AU - Niemeyer, Thomas
AU - Morlock, Michael
AU - Püschel, Klaus
AU - Übeyli, Hüseyin
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Study Design: Ex vivo human cadaveric study. Objective: The development or progression of adjacent segment disease (ASD) after spine stabilization and fusion is a major problem in spine surgery. Apart from optimal balancing of the sagittal profile, dynamic instrumentation is often suggested to prevent or impede ASD. Hybrid instrumentation is used to gain stabilization while allowing motion to avoid hypermobility in the adjacent segment. In this biomechanical study, the effects of two different hybrid instrumentations on human cadaver spines were evaluated and compared with a rigid instrumentation. Methods: Eighteen human cadaver spines (T11-L5) were subdivided into three groups: rigid, dynamic, and hook comprising six spines each. Clinical parameters and initial mechanical characteristics were consistent among groups. All specimens received rigid fixation from L3-L5 followed by application of a free bending load of extension and flexion. The range of motion (ROM) for every segment was evaluated. For the rigid group, further rigid fixation from L1-L5 was applied. A dynamic Elaspine system (Spinelab AG, Winterthur, Switzerland) was applied from L1 to L3 for the dynamic group, and the hook group was instrumented with additional laminar hooks at L1-L3. ROM was then evaluated again. Results: There was no significant difference in ROM among the three instrumentation techniques. Conclusion: Based on this data, the intended advantage of a hybrid or dynamic instrumentation might not be achieved.
AB - Study Design: Ex vivo human cadaveric study. Objective: The development or progression of adjacent segment disease (ASD) after spine stabilization and fusion is a major problem in spine surgery. Apart from optimal balancing of the sagittal profile, dynamic instrumentation is often suggested to prevent or impede ASD. Hybrid instrumentation is used to gain stabilization while allowing motion to avoid hypermobility in the adjacent segment. In this biomechanical study, the effects of two different hybrid instrumentations on human cadaver spines were evaluated and compared with a rigid instrumentation. Methods: Eighteen human cadaver spines (T11-L5) were subdivided into three groups: rigid, dynamic, and hook comprising six spines each. Clinical parameters and initial mechanical characteristics were consistent among groups. All specimens received rigid fixation from L3-L5 followed by application of a free bending load of extension and flexion. The range of motion (ROM) for every segment was evaluated. For the rigid group, further rigid fixation from L1-L5 was applied. A dynamic Elaspine system (Spinelab AG, Winterthur, Switzerland) was applied from L1 to L3 for the dynamic group, and the hook group was instrumented with additional laminar hooks at L1-L3. ROM was then evaluated again. Results: There was no significant difference in ROM among the three instrumentation techniques. Conclusion: Based on this data, the intended advantage of a hybrid or dynamic instrumentation might not be achieved.
KW - adjacent segment disease
KW - degenerative lumbar spine
KW - dynamic stabilization
KW - Elaspine
KW - hybrid instrumentation
KW - laminar hooks
KW - lumbar fusion
UR - http://www.scopus.com/inward/record.url?scp=85020797403&partnerID=8YFLogxK
U2 - 10.1055/s-0036-1583945
DO - 10.1055/s-0036-1583945
M3 - Article
VL - 7
SP - 47
EP - 53
JO - Global Spine Journal
JF - Global Spine Journal
SN - 2192-5682
IS - 1
ER -