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A Mouse Model of Lumbar Spine Instability
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Adjustable Rigid Interspinous Process Fixation: A Biomechanical Study of Segmental Lordosis and Interbody Loading in
Anup Gandhi1, Chris Ferry2, Jason A Inzana3
1Orthopaedics, Zimmer Biomet Spine, Westminster, USA.
Cureus
|June 12, 2019
Summary
This study found that a novel interspinous process fixation (ISPF) device effectively manages interbody load and focal lordosis, comparable to bilateral pedicle screw fixation (BPSF) in lumbar fusion. Incremental adjustments showed safe loading trends.
Area of Science:
- Spine Biomechanics
- Orthopedic Surgery
- Spinal Fusion Devices
Background:
- Rigid interspinous process fixation (ISPF) is a minimally disruptive option for lumbar interbody fusion.
- Previous studies show ISPF excels in sagittal plane stabilization.
- ISPF's impact on interbody load, cage migration, subsidence, and sagittal alignment requires further characterization.
Purpose of the Study:
- To biomechanically evaluate a novel ISPF device's effect on interbody load (IBL), focal lordosis (FL), and spinous process loading.
- To compare the novel ISPF device against bilateral pedicle screw fixation (BPSF) in vitro.
- To assess the impact of incremental in situ adjustments of the ISPF device.
Main Methods:
- Two human lumbar spines (seven functional spinal units) were tested.
- Standard lateral discectomy and cage placement with load cells were performed.
- Bilateral pedicle screw fixation (BPSF) and the novel ISPF device were applied sequentially and randomized.
Main Results:
- No significant differences in interbody load (IBL) were found between ISPF and BPSF.
- The ISPF device demonstrated a significantly greater change in focal lordosis (FL) compared to BPSF compression.
- ISPF device height correlated linearly with IBL during compression and exponentially during distraction.
Conclusions:
- The novel ISPF device achieves clinically effective interbody load and focal lordosis, performing comparably to BPSF.
- Incremental manipulation of the ISPF device showed predictable and safe loading patterns for the interbody space and spinous processes.
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