19 Harley St, London, W1G 9QJ, UK

Biomechanical analysis of osteotomy type and rod diameter for treatment of cervicothoracic kyphosis

STUDY DESIGN: Biomechanical laboratory research. OBJECTIVE: To characterize the structural stiffness of opening and closing wedge osteotomies and the independent effect of rod diameter. SUMMARY OF BACKGROUND DATA: Traditionally, C7 opening wedge osteotomy (OWO) has been performed for patients with ankylosing spondylitis. For patients without ankylosing spondylitis, closing wedge osteotomy (CWO) may be considered for more controlled closure. Biomechanical characteristics of the two osteotomy alternatives have not yet been analyzed. METHODS: Nondestructive pure moment flexion/extension (FE), lateral bending (LB), and axial rotation (AR) tests were conducted to 4.5 Nm on cadaveric specimens (C4-T3). All specimens underwent posterior bilateral screw-rod fixation with 3.5 mm and 4.5 mm Ti rods, whereas half received OWO and half received CWO. RESULTS: Independent of osteotomy type, constructs with 4.5 mm rods exhibited a significant increase in stiffness compared to 3.5 mm rods in all bending modes (P < 0.01). Relative to 3.5 mm rods, 4.5 mm constructs showed an increase in stiffness of 31 +/- 12% for FE, 37 +/- 39% for LB, and 31 +/- 11% for AR. At the osteotomy site, there was a 43 +/- 23% increase in FE stiffness, 45 +/- 36% in LB, and 41 +/- 17% in AR. Independent of rod diameter, CWO was significantly stiffer than OWO (42% for the construct and 56% across the osteotomy) in FE bending only (P < 0.05). CONCLUSION: The surgeon can expect a similar increase in stiffness in switching from 3.5 mm to 4.5 mm rod independent of osteotomy type. The increased stiffness of CWOs has an anatomic basis. OWOs disrupt the anterior longitudinal ligament (ALL) and leave a significant anterior gap whereas CWOs create a wedge through the vertebral body and leave the ALL and the discs above and below the osteotomy intact. The closure in CWOs leaves no anterior gap providing greater axial loading stability. This greater bone on bone contact in CWOs is likely a significant reason for the anterior stiffness and may provide greater fusion rates in the nonankylosing spondylitis patient population Keywords : Aged,Aged,80 and over,Biomechanical Phenomena,Bone Nails,Cadaver,Cervical Vertebrae,Female,Humans,instrumentation,Kyphosis,Male,methods,Middle Aged,Osteotomy,pathology,physiopathology,Range of Motion,Articular,Rotation,surgery,Thoracic Vertebrae,Treatment Outcome,, Analysis,Osteotomy,Type, acupuncture for costochondritis

Date of Publication : 2011 Apr 15

Authors : Scheer JK;Tang JA;Buckley JM;Deviren V;Pekmezci M;McClellan RT;Ames CP;

Organisation : Biomechanical Testing Facility, Orthopaedic Trauma Institute, San Francisco General Hospital, San Francisco, CA, USA. Justin.Scheer@gmail.com

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21245784

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Doctors Specialising in Thoracic Spine Trauma
Mr Mo Akmal MD
Mr Mo Akmal, MD, stands as a innovator in the ...

Related Posts

0/5 (0 Reviews)

Trusindex Reviews

London Spine Unit Harley Street Hospital

A Focus on High Quality Specialised Care

We are a specialist Private Hospital based on Harley Street, London UK The Harley Street Hospital, Day Surgery Hospital

We provide exclusive health services for individuals seeking Advanced medical, non-surgical or minimally invasive treatments. We are covered by All Insurance Companies apart from AXA PPP

Our Medical Director and Lead Spinal Surgeon Mr Mo Akmal MD is a world renowned Spine Specialist Consultant with over 20 years of experience. He and his team have developed revolutionary techniques to perform all types of Spinal Surgery as a Day Case procedure without traditional General Anaesthetic.

We are constantly improving our techniques for treatment and improving facilities for our patients.

Book your Appointment Now 
Check out our Reviews 
Check out our Patient Videos 
Check our Mr Akmal’s Profile

 

What our patients say ...

Biomechanical analysis of osteotomy type and rod diameter for treatment of cervicothoracic kyphosis | Https//wwwenglandnhsuk/commissioning/wp-content/uploads/sites/12/2015/10/d14-pa-cerv-disc-replcmnt-spnl-degenpdf

Revolutionary Keyhole surgical technique to vaporise bulging discs

Dr Mo Akmal Medical Director
Dr Mo Akmal MD - Lead Spinal Surgeon

Laser Disc Surgery can be performed under local anaesthetic at The Harley Street Hospital.

Initial Consultation

with Consultant Spine Surgeon
£ 250
  • No Waiting Times
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion
  • Review of Previous Scans and Reports

Follow up Consultation

any appointment after initial consultation
£ 180
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion

High Resolution MRI Scan

any Single Region (3.0 Tesla)
£ 600
  • No waiting times
  • Includes Full Radiologist Report
  • Open or Closed MRI scan types
  • Copy of Scan on CD

Website Offer

Pre-Booked Online
£1130
£ 800
  • Initial Consultation
  • MRI Scan (Single Region)
  • Follow Up consultation
  • Same Day One Stop Visit
  • Full Medical and MRI scan Report
  • Copy of scan on CD
Popular

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810