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Related Experiment Videos

Neuropathologic changes with experimental spinal instrumentation: transpedicular versus sublaminar fixation.

T A Zdeblick1, P S Becker, P C McAfee

  • 1Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, Maryland.

Journal of Spinal Disorders
|June 1, 1991
PubMed
Summary

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Sublaminar instrumentation for spinal fusion in beagles showed a higher incidence of neuropathologic abnormalities compared to pedicle screw or no instrumentation. Pedicle screws confirmed their theoretical advantage in avoiding spinal canal violation.

Area of Science:

  • Veterinary Medicine
  • Neurosurgery
  • Spinal Surgery

Background:

  • Spinal fusion aims to stabilize the spine but carries risks of spinal cord injury.
  • Instrumentation techniques vary in their invasiveness and potential for neurological complications.

Purpose of the Study:

  • To compare the neuropathologic outcomes of different spinal fusion instrumentation techniques in a canine model.
  • To evaluate the safety and efficacy of sublaminar wires versus pedicle screws for lumbar spine fusion.

Main Methods:

  • Fifty-six beagles underwent lumbar spine destabilization and fusion using four methods: bone graft alone, pedicle screws (Cotrel-Dubousset and Steffee), and sublaminar wires.
  • Spinal cord neuropathologic analysis was performed after 6 months.

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Main Results:

  • No animals showed clinical neurological deficits.
  • Moderate to severe neuropathologic changes occurred in 21% (bone graft), 18% (pedicle screws), and 64% (sublaminar wires).
  • Sublaminar instrumentation resulted in a significantly higher incidence of abnormalities compared to pedicle screws or no instrumentation (p=0.027).

Conclusions:

  • Sublaminar instrumentation is associated with a higher risk of spinal cord neuropathologic changes.
  • Pedicle screw instrumentation offers a safer alternative by avoiding direct entry into the spinal canal.
  • This animal study validates the theoretical benefits of pedicle screws over sublaminar devices.