The role of supplemental translaminar screws in anterior lumbar interbody fixation: A biomechanical study

被引：65

作者：

Rathonyi G.C. ^{[1
]}

Oxland T.R. ^{[2
,3
]}

Gerich U. ^{[2
]}

Grassmann S. ^{[2
]}

Nolte L.-P. ^{[2
]}

机构：

[1] National Center for Spinal Disorders, Semmelweis University, Budapest

[2] Maurice E. Muller Inst. for Biomech., University of Bern, Bern

[3] Department of Orthopaedics, University of British Columbia, Vancouver, BC V5Z 4E3

来源：

European Spine Journal | 1998年 / 7卷 / 5期

关键词：

Biomechanics; Implant; Interbody fusion; Stability; Translaminar screws;

D O I：

10.1007/s005860050097

中图分类号：

学科分类号：

摘要：

The immediate stabilization provided by anterior interbody cage fixation is often questioned. Therefore, the role of supplementary posterior fixation, particularly minimally invasive techniques such as translaminar screws, is relevant. The purpose of this biomechanical study was to determine the immediate three-dimensional flexibility of the lumbar spine, using six human cadaveric functional spinal units, in four different conditions: (1) intact, (2) fixed with translaminar screws (TLS), (3) instrumented with anterior interbody cage insertion with the BAK system and (4) instrumented with BAK cage with additional TLS fixation. Flexibility was determined in each testing condition by measuring the vertebral motions under applied pure moments (i.e. flexion-extension, bilateral axial rotation, bilateral lateral bending) in an unconstrained manner. Anterior fixation with the BAK alone provided significant stability in flexion and lateral bending. Additional posterior TLS significantly reduced the motion in extension and axial rotation. TLS fixation alone resulted in smaller rotations than BAK fixation in all loading directions. Based on these results, it seems that interbody cage fixation with the BAK system stabilizes the spine in some, but not all, loading directions. The problematic loading directions of extension and axial rotation can be substantially stabilized by using translaminar screw fixation. However, one should emphasize that the degree of stability needed to achieve solid fusion is not known.

引用

页码：400 / 407

页数：7

共 28 条

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