지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 680 - 688 (9page)
이용수
초록· 키워드
오류제보하기
Objective : To mitigate the risk of iatrogenic instability, new posterior decompression techniques able to preserve musculoskeletal structures have been introduced but never extensively investigated from a biomechanical point of view. This study was aimed to investigate the impact on spinal flexibility caused by a unilateral laminotomy for bilateral decompression, in comparison to the intact condition and a laminectomy with preservation of a bony bridge at the vertebral arch. Secondary aims were to investigate the biomechanical effects of two-level decompression and the quantification of the restoration of stability after posterior fixation. Methods : A universal spine tester was used to measure the flexibility of six L2-L5 human spine specimens in intact conditions and after decompression and fixation surgeries. An incremental damage protocol was applied : 1) unilateral laminotomy for bilateral decompression at L3-L4; 2) on three specimens, the unilateral laminotomy was extended to L4-L5; 3) laminectomy with preservation of a bony bridge at the vertebral arch (at L3-L4 in the first three specimens and at L4-L5 in the rest); and 4) pedicle screw fixation at the involved levels. Results : Unilateral laminotomy for bilateral decompression had a minor influence on the lumbar flexibility. In flexion-extension, the median range of motion increased by 8%. The bone-preserving laminectomy did not cause major changes in spinal flexibility. Two-level decompression approximately induced a twofold destabilization compared to the single-level treatment, with greater effect on the lower level. Posterior fixation reduced the flexibility to values lower than in the intact conditions in all cases. Conclusion : In vitro testing of human lumbar specimens revealed that unilateral laminotomy for bilateral decompression and bone-preserving laminectomy induced a minor destabilization at the operated level. In absence of other pathological factors (e.g., clinical instability, spondylolisthesis), both techniques appear to be safe from a biomechanical point of view.
목차
등록된 정보가 없습니다.
참고문헌 (33)
참고문헌 신청
Airaksinen O / 1997 / Surgical outcome of 438 patients treated surgically for lumbar spinal stenosis / Spine (Phila Pa 1976) 22:2278~2282
Allen BL Jr / 1987 / The biomechanics of decompressive laminectomy / Spine (Phila Pa 1976) 12:803~808
Bisschop A / 2013 / Which factors prognosticate rotational instability following lumbar laminectomy? / Eur Spine J 22:2897~2903
Bisschop A / 2014 / Single level lumbar laminectomy alters segmental biomechanical behavior without affecting adjacent segments / Clin Biomech (Bristol, Avon) 29:912~917
Bisschop A / 2012 / Which factors prognosticate spinal instability following lumbar laminectomy? / Eur Spine J 21:2640~2648
Allen BL Jr / 1987 / The biomechanics of decompressive laminectomy / Spine (Phila Pa 1976) 12:803~808
Bisschop A / 2013 / Which factors prognosticate rotational instability following lumbar laminectomy? / Eur Spine J 22:2897~2903
Bisschop A / 2014 / Single level lumbar laminectomy alters segmental biomechanical behavior without affecting adjacent segments / Clin Biomech (Bristol, Avon) 29:912~917
Bisschop A / 2012 / Which factors prognosticate spinal instability following lumbar laminectomy? / Eur Spine J 21:2640~2648
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