Biomechanical stability afforded by unilateral vs. bilateral pedicle screw fixation with and with out interbody help utilizing lateral lumbar interbody fusion.
World Neurosurg. 2018 Feb 17;:
Authors: Godzik J, Martinez-Del-Campo E, Newcomb AGUS, Reis MT, Perez-Orribo L, Whiting AC, Singh V, Kelly BP, Crawford NR
OBJECTIVE: To find out the soundness of fusion constructs with unilateral pedicle screw (UPS) or bilateral pedicle screw (BPS) fixation with and with out an interbody implant utilizing the lateral lumbar interbody (LLIF) method.
METHODS: Commonplace nondestructive flexibility assessments had been carried out on 13 cadaveric lumbar specimens to evaluate spinal stability of intact specimens and 5 configurations of posterior and interbody instrumentation. Spinal stability was decided as imply vary of movement in flexion-extension, lateral bending, and axial rotation. Nonpaired comparisons had been made for these 6 situations: (1) intact; (2) unilateral interbody utilizing LLIF method (LLIF assemble); (three) unilateral interbody+unilateral pedicle screws (UPS) utilizing LLIF method (LLIF+UPS); four) unilateral interbody+bilateral pedicle screws (BPS) utilizing LLIF method (LLIF+BPS) (5) UPS alone; and (6) BPS alone.
RESULTS: UPS and BPS, with and with out interbody help, considerably lowered vary of movement throughout the vast majority of instructions of loading. BPS alone offered higher stability than UPS alone and LLIF alone in all instructions of movement besides axial rotation. With interbody help, there was no vital distinction in stability between BPS and UPS throughout all motion instructions.
CONCLUSIONS: These biomechanical outcomes counsel that fixation within the lumbar backbone with an interbody help utilizing a LLIF method with UPS is a promising different to BPS. Though BPS gives higher fast stability in comparison with UPS, within the presence of a lateral interbody implant, UPS and BPS present equal stability. Moreover, LLIF doesn’t seem to contribute considerably to fast stability when BPS is used.
PMID: 29462730 [PubMed – as supplied by publisher]