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Lumbar intrafacet bone dowel fixation.

Daniel J Cook1, Matthew S Yeager, Michael Y Oh

  • 1*Department of Neurosurgery, Allegheny Health Network, Pittsburgh, Pennsylvania; ‡Department of Neurosurgery, Allegheny Health Network, Drexel University College of Medicine, Pittsburgh, Pennsylvania.

Neurosurgery
|January 27, 2015
PubMed
Summary
This summary is machine-generated.

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Intrafacet bone dowels showed limited efficacy for lumbar fusion, with one device providing temporary stability. Significant device migration and extrusion were observed, questioning their clinical utility.

Area of Science:

  • Spinal surgery
  • Orthopedic biomechanics
  • Lumbar fusion technologies

Background:

  • The effectiveness of intrafacet bone dowels for lumbar fusion remains unproven.
  • Previous research suggests low fusion rates and device migration issues.

Purpose of the Study:

  • To assess the mechanical stability of two lumbar facet fixation technologies.
  • Evaluate stability before and after cyclic loading to simulate physiological conditions.

Main Methods:

  • Six human lumbar spine specimens were used.
  • Two allograft types were implanted at L2-3 and L4-5.
  • Flexibility testing and CT scans were performed pre- and post-cyclic loading.

Main Results:

  • Only one dowel type significantly reduced motion at baseline and after 2500 cycles.

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  • This effect was not sustained after 5000 cycles.
  • Posterior extrusion of a bone dowel occurred during initial testing.

    • Conclusions:

    • Cylindrical bone dowels demonstrate insufficient fixation efficacy in the lumbar facet joint.
    • Temporary fixation was observed with one device, but it diminished with loading.
    • Significant device migration was a notable finding.