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Interspinous and spinolaminar synthetic vertebropexy of the lumbar spine


Calek, Anna-Katharina; Altorfer, Franziska; Fasser, Marie-Rosa; Widmer, Jonas; Farshad, Mazda (2023). Interspinous and spinolaminar synthetic vertebropexy of the lumbar spine. European Spine Journal, 32(9):3183-3191.

Abstract

PURPOSE: To develop and test synthetic vertebral stabilization techniques ("vertebropexy") that can be used after decompression surgery and furthermore to compare them with a standard dorsal fusion procedure.
METHODS: Twelve spinal segments (Th12/L1: 4, L2/3: 4, L4/5: 4) were tested in a stepwise surgical decompression and stabilization study. Stabilization was achieved with a FiberTape cerclage, which was pulled through the spinous process (interspinous technique) or through one spinous process and around both laminae (spinolaminar technique). The specimens were tested (1) in the native state, after (2) unilateral laminotomy, (3) interspinous vertebropexy and (4) spinolaminar vertebropexy. The segments were loaded in flexion-extension (FE), lateral shear (LS), lateral bending (LB), anterior shear (AS) and axial rotation (AR).
RESULTS: Interspinous fixation significantly reduced ROM in FE by 66% (p = 0.003), in LB by 7% (p = 0.006) and in AR by 9% (p = 0.02). Shear movements (LS and AS) were also reduced, although not significantly: in LS reduction by 24% (p = 0.07), in AS reduction by 3% (p = 0.21). Spinolaminar fixation significantly reduced ROM in FE by 68% (p = 0.003), in LS by 28% (p = 0.01), in LB by 10% (p = 0.003) and AR by 8% (p = 0.003). AS was also reduced, although not significantly: reduction by 18% (p = 0.06). Overall, the techniques were largely comparable. The spinolaminar technique differed from interspinous fixation only in that it had a greater effect on shear motion.
CONCLUSION: Synthetic vertebropexy is able to reduce lumbar segmental motion, especially in flexion-extension. The spinolaminar technique affects shear forces to a greater extent than the interspinous technique.

Abstract

PURPOSE: To develop and test synthetic vertebral stabilization techniques ("vertebropexy") that can be used after decompression surgery and furthermore to compare them with a standard dorsal fusion procedure.
METHODS: Twelve spinal segments (Th12/L1: 4, L2/3: 4, L4/5: 4) were tested in a stepwise surgical decompression and stabilization study. Stabilization was achieved with a FiberTape cerclage, which was pulled through the spinous process (interspinous technique) or through one spinous process and around both laminae (spinolaminar technique). The specimens were tested (1) in the native state, after (2) unilateral laminotomy, (3) interspinous vertebropexy and (4) spinolaminar vertebropexy. The segments were loaded in flexion-extension (FE), lateral shear (LS), lateral bending (LB), anterior shear (AS) and axial rotation (AR).
RESULTS: Interspinous fixation significantly reduced ROM in FE by 66% (p = 0.003), in LB by 7% (p = 0.006) and in AR by 9% (p = 0.02). Shear movements (LS and AS) were also reduced, although not significantly: in LS reduction by 24% (p = 0.07), in AS reduction by 3% (p = 0.21). Spinolaminar fixation significantly reduced ROM in FE by 68% (p = 0.003), in LS by 28% (p = 0.01), in LB by 10% (p = 0.003) and AR by 8% (p = 0.003). AS was also reduced, although not significantly: reduction by 18% (p = 0.06). Overall, the techniques were largely comparable. The spinolaminar technique differed from interspinous fixation only in that it had a greater effect on shear motion.
CONCLUSION: Synthetic vertebropexy is able to reduce lumbar segmental motion, especially in flexion-extension. The spinolaminar technique affects shear forces to a greater extent than the interspinous technique.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
04 Faculty of Medicine > Institute of Molecular Cancer Research
07 Faculty of Science > Institute of Molecular Cancer Research
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Scopus Subject Areas:Health Sciences > Surgery
Health Sciences > Orthopedics and Sports Medicine
Language:English
Date:September 2023
Deposited On:30 Aug 2023 10:55
Last Modified:29 Jun 2024 01:38
Publisher:Springer
ISSN:0940-6719
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1007/s00586-023-07798-y
PubMed ID:37284900
  • Content: Published Version
  • Language: English
  • Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)