Abstract
Summary of background data: Previous work has demonstrated the efficacy of lumbar pedicle screw hook rod (PSHR) techniques and the Buck screw in the stabilization of spondylolysis. The mechanical behavior of lower profile cervical implants used to create PSHR, hybrid cable plate constructs, and titanium miniplating has not previously been described. Methods: Calf lumbar spines (L2-L6) were utilized for testing (n=27) Intervertebral rotation was measured in the intact spines across the L4-5 segment before and after creation of bilateral pars interarticularis defects. Defects were then stabilized with one of three repair techniques, PSHR, miniplate, or cable plate (CP) constructs. (n=9) A 5-Nm load was applied in flexion-extension, lateral bending and axial rotation. Fracture displacement was measured under flexion-extension and lateral bending modes. Results: Osteotomy of the pars interarticularis increased intervertebral rotation from 4.6° to 9.2° (P<.05). The three techniques of repair reduced intervertebral rotation without statistical superiority of one method. In lateral bending the miniplate was most effective in reducing pars defect displacement (0.6mm, P<0.05). Although, the miniplate provided lower defect displacement in flexion-extension and axial rotation, these differences were not statistically significant. Conclusions: Bilateral miniplate fixation demonstrates superiority in restoring stability in lateral bending as compared to pedicle screw hook rod techniques and cable plate constructs. In flexion-extension and axial rotation, it was as effective as a PSHR method. Consideration of anatomic plate designs warrants consideration. Level of evidence: IV.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 66-71 |
| Number of pages | 6 |
| Journal | Orthopaedics and Traumatology: Surgery and Research |
| Volume | 99 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 2013 |
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Keywords
- Biomechanical testing
- Isthmus repair
- Pars interarticularis
- Spinal stability
- Spondylolysis
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Surgery
Cite this
A biomechanical comparison of three spondylolysis repair techniques in a calf spine model. / Roberto, Rolando Figueroa; Dezfuli, B.; Deuel, C.; Curtiss, S.; Hazelwood, S.
In: Orthopaedics and Traumatology: Surgery and Research, Vol. 99, No. 1, 02.2013, p. 66-71.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A biomechanical comparison of three spondylolysis repair techniques in a calf spine model
AU - Roberto, Rolando Figueroa
AU - Dezfuli, B.
AU - Deuel, C.
AU - Curtiss, S.
AU - Hazelwood, S.
PY - 2013/2
Y1 - 2013/2
N2 - Summary of background data: Previous work has demonstrated the efficacy of lumbar pedicle screw hook rod (PSHR) techniques and the Buck screw in the stabilization of spondylolysis. The mechanical behavior of lower profile cervical implants used to create PSHR, hybrid cable plate constructs, and titanium miniplating has not previously been described. Methods: Calf lumbar spines (L2-L6) were utilized for testing (n=27) Intervertebral rotation was measured in the intact spines across the L4-5 segment before and after creation of bilateral pars interarticularis defects. Defects were then stabilized with one of three repair techniques, PSHR, miniplate, or cable plate (CP) constructs. (n=9) A 5-Nm load was applied in flexion-extension, lateral bending and axial rotation. Fracture displacement was measured under flexion-extension and lateral bending modes. Results: Osteotomy of the pars interarticularis increased intervertebral rotation from 4.6° to 9.2° (P<.05). The three techniques of repair reduced intervertebral rotation without statistical superiority of one method. In lateral bending the miniplate was most effective in reducing pars defect displacement (0.6mm, P<0.05). Although, the miniplate provided lower defect displacement in flexion-extension and axial rotation, these differences were not statistically significant. Conclusions: Bilateral miniplate fixation demonstrates superiority in restoring stability in lateral bending as compared to pedicle screw hook rod techniques and cable plate constructs. In flexion-extension and axial rotation, it was as effective as a PSHR method. Consideration of anatomic plate designs warrants consideration. Level of evidence: IV.
AB - Summary of background data: Previous work has demonstrated the efficacy of lumbar pedicle screw hook rod (PSHR) techniques and the Buck screw in the stabilization of spondylolysis. The mechanical behavior of lower profile cervical implants used to create PSHR, hybrid cable plate constructs, and titanium miniplating has not previously been described. Methods: Calf lumbar spines (L2-L6) were utilized for testing (n=27) Intervertebral rotation was measured in the intact spines across the L4-5 segment before and after creation of bilateral pars interarticularis defects. Defects were then stabilized with one of three repair techniques, PSHR, miniplate, or cable plate (CP) constructs. (n=9) A 5-Nm load was applied in flexion-extension, lateral bending and axial rotation. Fracture displacement was measured under flexion-extension and lateral bending modes. Results: Osteotomy of the pars interarticularis increased intervertebral rotation from 4.6° to 9.2° (P<.05). The three techniques of repair reduced intervertebral rotation without statistical superiority of one method. In lateral bending the miniplate was most effective in reducing pars defect displacement (0.6mm, P<0.05). Although, the miniplate provided lower defect displacement in flexion-extension and axial rotation, these differences were not statistically significant. Conclusions: Bilateral miniplate fixation demonstrates superiority in restoring stability in lateral bending as compared to pedicle screw hook rod techniques and cable plate constructs. In flexion-extension and axial rotation, it was as effective as a PSHR method. Consideration of anatomic plate designs warrants consideration. Level of evidence: IV.
KW - Biomechanical testing
KW - Isthmus repair
KW - Pars interarticularis
KW - Spinal stability
KW - Spondylolysis
UR - http://www.scopus.com/inward/record.url?scp=84873261443&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873261443&partnerID=8YFLogxK
U2 - 10.1016/j.otsr.2012.10.011
DO - 10.1016/j.otsr.2012.10.011
M3 - Article
VL - 99
SP - 66
EP - 71
JO - Orthopaedics and Traumatology: Surgery and Research
JF - Orthopaedics and Traumatology: Surgery and Research
SN - 1877-0568
IS - 1
ER -