The effect of interspinous ligament integrity on adjacent segment instability after lumbar instrumentation and laminectomy - An experimental study in porcine model

Lih-Huei Chen, Po-Liang Lai, Ching Lung Tai, Chi Chien Niu, Tsai-Sheng Fu, Wen-Jer Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

29 Scopus citations

Abstract

Eight fresh porcine lumbar spines received a posterior instrumentation at L4-L5 using pedicle screw-rod system. Each specimen was tested utilizing laminectomies of varying extent. Group A (Integrity) preserved the spinous process and interspinous ligament; Group B (Partial laminectomy) removed the inferior portion of L4 spinous process and preserved the interspinous ligament of L3-L4; Group C (Complete laminectomy) removed the entire L4 spinous process. Hydraulic testing machine was used to generate an increasing moment up to 8400 N mm in flexion and extension. The intervertebral displacement on the superior adjacent disc between L3-L4 was measured using an extensometer. Under extension, no significant difference in the intervertebral displacement was observed among three different models of laminectomy. However, under flexion, the intervertebral displacement on adjacent disc with complete laminectomy was statistically larger than those of integrity and partial laminectomies (P = 0.000976 and P = 0.0363, respectively). No difference was found between integrity and partial laminectomy groups (P > 0.05). This study implies that an instrumented spine with integrity of posterior complex is less likely to develop adjacent instability than a spine with destruction of the anchoring point for supraspinous ligament.

Original languageEnglish
Pages (from-to)261-267
Number of pages7
JournalBio-Medical Materials and Engineering
Volume16
Issue number4
StatePublished - 2006

Keywords

  • Adjacent segment
  • Interspinous ligament
  • Pedicle screw fixation
  • Porcine model
  • Spinal fusion

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