Biomechanical stability afforded by unilateral vs. bilateral pedicle screw fixation with and with out interbody assist 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 steadiness 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) strategy.
METHODS: Customary nondestructive flexibility checks have 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 have been made for these 6 situations: (1) intact; (2) unilateral interbody utilizing LLIF strategy (LLIF assemble); (three) unilateral interbody+unilateral pedicle screws (UPS) utilizing LLIF strategy (LLIF+UPS); four) unilateral interbody+bilateral pedicle screws (BPS) utilizing LLIF strategy (LLIF+BPS) (5) UPS alone; and (6) BPS alone.
RESULTS: UPS and BPS, with and with out interbody assist, considerably diminished vary of movement throughout nearly all of instructions of loading. BPS alone offered better stability than UPS alone and LLIF alone in all instructions of movement besides axial rotation. With interbody assist, there was no vital distinction in stability between BPS and UPS throughout all motion instructions.
CONCLUSIONS: These biomechanical outcomes recommend that fixation within the lumbar backbone with an interbody assist utilizing a LLIF strategy with UPS is a promising various to BPS. Though BPS gives better instant 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 instant stability when BPS is used.
PMID: 29462730 [PubMed – as supplied by publisher]