Intraoperative measurement of lumbar spine motion segment stiffness

Study Design. Prospective trial. Objectives. To test an intraoperative diagnostic tool to determine if it provided the surgeon with a safe, reproducible, accurate, quantitative measure of lumbar spine motion segment stability. Summary of Background Data. Several devices have been developed to measure motion segment stiffness, however, few have been tested intraoperatively on humans, and none, to the best of the authors' knowledge have been tested as extensively as the device described in this study. Objective criteria, such as those provided by an intraoperative gauge, can be helpful in determining when and what type of fusion of a degenerated spinal motion segment unit should be performed following decompressive surgery. Methods. The spinal stiffness gauge, placed between spinous processes of adjacent vertebrae, applies a controlled, constant loading rate along the spine's longitudinal axis, producing a load-displacement curve from which stiffness, range of motion, and hysteresis can be computed. Measurements from this tool were then used to investigate differences in stiffness of the motion segment before and after decompressive surgery, between spine levels, and between male and female subjects. Results. The spinal stiffness gauge stiffness measurements correlated with the surgeon's subjective stiffness measurements on the same motion segments. The stiffness measurements had excellent repeatability. Stiffness was dependent on the spine level, gender, and degree of disc degeneration. Conclusions. This study demonstrated the efficacy of the spinal stiffness gauge for providing an objective, quantitative, intraoperative stiffness (stability) measurement of the lumbar spine motion segment.