19 Harley St, London, W1G 9QJ, UK

Kinematics of progressive circumferential ligament resection (decompression) in conjunction with cervical disc arthroplasty in a spondylotic spine model

STUDY DESIGN: Benchtop biomechanics study examining kinematic effects of progressive resection in a human cadaveric spine model. OBJECTIVE: To determine the effects of posterior longitudinal ligament (PLL) resection, unilateral and bilateral foraminotomy, and laminectomy on cervical intervertebral rotation and translation after cervical disc arthroplasty (CDA). SUMMARY OF BACKGROUND DATA: Although the clinical results after CDA have been studied, there remain unanswered questions regarding the surgical techniques used at the time of device insertion. For example, it is unclear whether a surgeon should retain or resect the PLL and uncinate processes at the time of primary surgical intervention. Further, the effect of a subsequent posterior decompression (foraminotomy or laminectomy) on the stability of a motion segment containing a disc arthroplasty is unknown. METHODS: Three-dimensional intervertebral motion was measured by biplanar videography in human cadaveric spines at C4-C5 or at C5-C6 subjected to a 1.5-Nm moment applied to induce motion in the sagittal plane. Coupled motions were not constrained. After measuring intact spine motion, disc arthroplasty with bilateral ventral foraminotomy was performed without PLL resection. Sequentially, rotations and translations were measured after PLL resection, unilateral foraminotomy, bilateral foraminotomy, and laminectomy. RESULTS: CDA with bilateral ventral foraminotomy increased sagittal rotation by 0.4 degrees (16%) compared with the intact spine. The addition of PLL resection increased rotation by 0.5 degrees (14% increase). Unilateral and bilateral foraminotomy had negligible effects on sagittal rotation or anteroposterior (AP) translation. Laminectomy resulted in an additional sagittal plane rotation of 2 degrees. The sagittal-plane interverterbal rotation resultant after all interventions was 6 degrees , with 1.5 mm of AP translation occurring only. CONCLUSION: Given that a greater degree of motion was seen with PLL resection combined with ventral foraminotomy, we recommend that PLL resection be performed when performing CDA. In our benchtop model, unilateral and bilateral posterior foraminotomies were not associated with the creation of significant sagittal rotational or AP translational instability

Keywords : adverse effects,Aged,Aged,80 and over,Arthroplasty,Biomechanical Phenomena,California,Cervical Vertebrae,etiology,Humans,Intervertebral Disc Displacement,Laminectomy,Longitudinal Ligaments,methods,Middle Aged,Models,Anatomic,Motion,physiology,Postoperative Complications,prevention & control,Rotation,Spine,Spondylosis,standards,surgery,Time,, Progressive,Circumferential,Ligament,Resection, pain specialist

Date of Publication : 2010 Aug 15

Authors : Roberto RF;McDonald T;Curtiss S;Neu CP;Kim K;Pennings F;

Organisation : Department of Orthopaedic Surgery, University of California, Davis, Medical Center, Sacramento, CA 95817, USA. Rolando.Roberto@ucdmc.ucdavis.edu

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/20508554

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

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 ...

Kinematics of progressive circumferential ligament resection (decompression) in conjunction with cervical disc arthroplasty in a spondylotic spine model | Anyone had disc replacement surgery? | Golf monthly

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