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Three-dimensional stabilization provided by the external spinal fixator compared to two internal fixation devices: a
Teija Lund1, Thomas Nydegger, Gabor Rathonyi
1ORTON Orthopaedic Hospital, Invalid Foundation, Tenholantie 10, 00280, Helsinki, Finland. teija.lund@invalidisaatio.fi
Summary
The external spinal fixator (ESF) significantly stabilizes the lumbar spine, particularly in compression mode. It offers comparable or superior stabilization to internal fixation methods for low back pain assessment.
Area of Science:
- Orthopedics
- Spinal Surgery
- Biomechanics
Background:
- Spinal fixation techniques are crucial for managing low back pain.
- External spinal fixators (ESF) offer a potential solution for spinal stabilization.
Purpose of the Study:
- To evaluate the spinal stabilization provided by the external spinal fixator (ESF).
- To compare three ESF configurations against two internal fixation methods in cadaveric lumbar spine specimens.
Main Methods:
- Six human cadaveric lumbar spine specimens (L3-S1) underwent multidirectional flexibility testing.
- Testing included intact, ESF (neutral, distraction, compression), translaminar facet screw, and internal transpedicular fixation.
- Intervertebral rotations were measured using an optoelectronic system under applied moments.
Main Results:
- All ESF configurations significantly stabilized the L4-S1 segment compared to the intact spine.
- ESF in compression offered superior flexion-extension stabilization over other ESF modes.
- ESF demonstrated significant stabilization in flexion-extension compared to internal fixation, but was inferior to transpedicular fixation in lateral bending.
Conclusions:
- The external spinal fixator provides substantial spinal stabilization, suitable for preoperative assessment in selected low back pain patients.
- Further research is needed to understand non-mechanical factors influencing pain relief.