Pedicle distraction will increase intervertebral and spinal canal space in a cadaver and bone mannequin.
SICOT J. 2018;four:15
Authors: Hughes M, Papadakos N, Bishop T, Bernard J
INTRODUCTION: Lumbar spinal stenosis is degenerative narrowing of the spinal canal and/or intervertebral foramen inflicting compression of the spinal wire and nerve roots. Conventional decompression methods can usually trigger vital trauma and vertebral instability. This paper evaluates a way of accelerating pedicle size to decompress the spinal and intervertebral foramen, which could possibly be accomplished minimally invasive.
METHODS: Three Sawbone (Sawbones Europe, Sweden) and 1 cadaveric lumbar backbone underwent bilateral pedicle distraction at L4. A pedicle channel was drilled between the superior articular course of and transverse course of into the vertebral physique. The pedicles underwent osteotomy on the midpoint. Screws have been inserted bilaterally and fixated distraction of zero?mm, 2?mm, four?mm and 6?mm. CT pictures have been taken at every stage of distraction. Foramen space was measured within the sagittal airplane at L3/four. Spinal canal space was measured at L4 within the axial pictures. The cadaver was used to guage security of osteotomy and smooth tissue interactions stopping distraction. Statistical evaluation was by scholar paired t-test and Pearson rank check.
RESULTS: Rising distraction led to better Spinal canal space. From four.27?cm2 to five.72?cm2 (p?=?zero.002) with 6?mm distraction. A Maximal enhance of 34.1%. Vertebral foramen space additionally elevated with rising pedicle distraction. From 2.43?cm2 to three.22?cm2 (p?=?zero.zero22) with 6?mm distraction. A maximal enhance of 32.three%. The cadaver spinal canal elevated in space by 21.7%. The vertebral foramen elevated in space by 36.2% (left) and 22.6% (proper).
DISCUSSION: For every enhance in pedicle distraction the realm of the spinal and vertebral foramen will increase. Pedicle distraction may probably be used to alleviate spinal stenosis and root impingement. A possible osteotomy airplane could possibly be on the midpoint of the pedicle with minimal threat to nerve roots and smooth tissue restrictions to stop distraction.
PMID: 29727270 [PubMed]