Biomechanical effect of graded minimal-invasive decompression procedures on lumbar spinal stability

doi:10.1007/s00402-012-1543-2

Paper

Biomechanical effect of graded minimal-invasive decompression procedures on lumbar spinal stability

Published May 17, 2012 · F. Hartmann, Claudia Janssen, Susanne Böhm

Archives of Orthopaedic and Trauma Surgery

Q1 SJR score

24

Citations

1

Influential Citations

Full text

Semantic Scholar

Abstract

IntroductionDecompression surgery represents the standard operative treatment for lumbar spinal stenosis, but this procedure is often combined with fusion surgery. It is still discussed whether minimal-invasive decompression procedures are sufficient and if they compromise spinal stability as well. The aim of this study was to analyze the effects of different minimal-invasive decompression procedures on the range of motion (ROM) of the decompressed and adjacent segments under preload conditions.MethodsFourteen fresh frozen human cadaver lumbar spines (L2–L5) were tested in a spinal testing device with a moment of 7.5 N m in flexion/extension, lateral bending and rotation with and without a preload. The ROM of the decompressed segment L3/4 and the adjacent segments L2/L3 and L4/L5 was measured intact and after creating a gradual defect with resection of the interspinous ligament (ISL), bilateral undercutting decompression, detachment of the supraspinous ligament (SSL) and bilateral medial facetectomy.ResultsThe resection of the ISL had no significant effect on the ROM of all segments. Undercutting decompression showed a significant increase in the ROM of all segments during flexion/extension and lateral bending. The detachment of the SSL caused a significant increase of ROM during flexion/extension in the instrumented and adjacent segments. After bilateral medial facetectomy, a decrease of ROM was observed in all directions of motion except flexion/extension with preload.ConclusionsThe results support minimal-invasive procedures for the preservation of spinal stability. Therefore, surgeons can determine which grade of decompression procedure can be performed in the individual patient without requiring additional fusion to maintain spinal stability.

Rigorous Journal

Study Snapshot

Key takeawayMinimally invasive decompression procedures can preserve spinal stability, allowing surgeons to determine which grade of procedure is appropriate for individual patients without requiring additional fusion.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

Biomechanical effect of graded minimal-invasive decompression procedures on lumbar spinal stability

References

Citations