Effects of modified U-shaped interspinous distraction device on cadaveric intervertebral disc pressure

Authors

  • Chindanai Hongsaprabhas Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
  • Pibul Itiravivong Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Pairat Tangpornprasert Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
  • Chanyaphan Virulsi Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand

Keywords:

Interspinous, distraction device, modified U-shape device, tension wire loop, intervertebral disc pressure, biomechanical cadaveric study

Abstract

Background: Adjacent syndrome is a widely concerned adverse outcome after spinal fusion. Interspinous distraction device (IDD) has become an interesting device and seems to be the solution by theoretically controlling loads to adjacent levels.

Objective: To analyze the effects of a modified U-shape IDD on the intervertebral disc (IVD) pressure at instrumented and adjacent level of a lumbar spine model.

Methods: Three cadaveric specimens using lumbar vertebrae level 1 - 5 (L1 - L5) spines were loaded in neutral, flexion and extension. Needle pressure sensor was applied to measure IVD pressure at anterior annulus, nucleus pulposus, and posterior annulus of the IVD at L2 - L3, L3 - L4, and L4 - L5. Cadaveric specimens were tested in 4 consecutive sequences including intact specimen, bilateral facetectomy at L3 - L4, insertion of the modified U-shape IDD at L3 - L4, and pedicle screw fixation at L3 - L4, respectively.

Results: By using the modified U-shape IDD, the IVD pressures at L2 – L3 were decreased when compared to both destabilized specimen and specimen with pedicle screw fixation especially IVD pressure at nucleus pulposus in flexion position of cadaveric specimen (P = 0.021). However, the IVD pressures at L3 – L4 and L4 – L5 were randomly affected by this device.

Conclusions: The modified U-shape IDD provides support for the upper adjacent IVD pressures but the effect for the instrumented and lower adjacent level are still unremarkable.

Downloads

Download data is not yet available.

References

Verbiest H. A radicular syndrome from developmental narrowing of the lumbar vertebral canal. J Bone Joint Surg Br 1954;36-B:230-7. https://doi.org/10.1302/0301-620X.36B2.230

Kirkaldy-Willis WH, Wedge JH, Yong-Hing K, Reilly J. Pathology and pathogenesis of lumbar spondylosis and stenosis. Spine (Phila Pa 1976) 1978;3:319-28. https://doi.org/10.1097/00007632-197812000-00004

Boos N, Webb JK. Pedicle screw fixation in spinaldisorders: a European view. Eur Spine J 1997;6:2-18.

https://doi.org/10.1007/BF01676569

Dahl B, Gehrchen P, Blyme P, Kiaer T, Tondevold E. Clinical outcome after spinal fusion with a rigid versus a semi-rigid pedicle screw system. Eur Spine J 1997;6:412-6. https://doi.org/10.1007/BF01834071

Christensen FB, Thomsen K, Eiskjaer SP, Gelinick J, Bunger CE. Functional outcome after posterolateral spinal fusion using pedicle screws: comparison between primary and salvage procedure. Eur Spine J 1998;7:321-7. https://doi.org/10.1007/s005860050082

Gibson JN, Grant IC, Waddell G. The Cochrane review of surgery for lumbar disc prolapse and degenerative lumbar spondylosis. Spine (Phila Pa 1976) 1999;24:820-32.

https://doi.org/10.1097/00007632-199909010-00012

Bjarke Christensen F, Stender Hansen E, Laursen M, Thomsen K, Bunger CE. Long-term functional outcome of pedicle screw instrumentation as a support for posterolateral spinal fusion: randomized clinical study with a 5-year follow-up. Spine (Phila Pa 1976) 2002;27:1269-77.

https://doi.org/10.1097/00007632-200206150-00006

Tantavisut S. Measurement of Interspinous distance of Thai population in MRI and new design Interspinous dynamic stabilization system of the lumbar spine [thesis]. Bangkok: Chulalongkorn University; 2007.

Tantavisut S, Ittiravivong P, Tangpornprasert P, Virulsi C, Tejapongvorachai T. Magnetic resonance imaging based lumbar interspinous distance measurements in Thai subjects. Chula Med J 2012;56:297-305.

Wilke H, Neef P, Hinz B, Seidel H, Claes L. Intradiscal pressure together with anthropometric data-a data set for the validation of models. Clin Biomech (Bristol, Avon) 2001;16 Suppl 1:S111-26.

https://doi.org/10.1016/S0268-0033(00)00103-0

Nachemson AL. Disc pressure measurements. Spine (Phila Pa 1976) 1981;6:93-7.

https://doi.org/10.1097/00007632-198101000-00020

Abumi K, Panjabi MM, Kramer KM, Duranceau J, Oxland T, Crisco JJ. Biomechanical evaluation of lumbar spinal stability after graded facetectomies. Spine (Phila Pa 1976) 1990;15:1142-7.

https://doi.org/10.1097/00007632-199011010-00011

Yue JJ, Bertagnoli R, McAfee McAfee, An HS. Motion preservation surgery of the spine: advanced techniques and controversies. Philadelphia: Saunders Elsevier; 2008.

https://doi.org/10.3174/ajnr.A1707

Lindsey DP, Swanson KE, Fuchs P, Hsu KY, Zucherman JF, Yerby SA. The effects of an interspinous implant on the kinematics of the instrumented and adjacent levels in the lumbar spine. Spine (Phila Pa 1976) 2003;28:2192-7. https://doi.org/10.1097/01.BRS.0000084877.88192.8E

Minns RJ, Walsh WK. Preliminary design and experimental studies of a novel soft implant for correcting sagittal plane instability in the lumbar spine. Spine (Phila Pa 1976) 1997;22:1819-25.

https://doi.org/10.1097/00007632-199708150-00004

Swanson KE, Lindsey DP, Hsu KY, Zucherman JF, Yerby SA. The effects of an interspinous implant on intervertebral disc pressures. Spine (Phila Pa 1976) 2003;28:26-32.

https://doi.org/10.1097/00007632-200301010-00008

Phillips FM, Voronov LI, Gaitanis IN, Carandang G, Havey RM, Patwardhan AG. Biomechanics of posterior dynamic stabilizing device (DIAM) after facetectomy and discectomy. Spine J 2006;6:714-22.

https://doi.org/10.1016/j.spinee.2006.02.003

Tsai KJ, Murakami H, Lowery GL, Hutton WC. A biomechanical evaluation of an interspinous device (Coflex) used to stabilize the lumbar spine. J Surg Orthop Adv 2006;15:167-72.

Shim CS, Park SW, Lee SH, Lim TJ, Chun K, Kim DH. Biomechanical evaluation of an interspinous stabilizing device, Locker. Spine (Phila Pa 1976) 2008;33:E820-7.

https://doi.org/10.1097/BRS.0b013e3181894fb1

Gedet P, Haschtmann D, Thistlethwaite PA, Ferguson SJ. Comparative biomechanical investigation of a modular dynamic lumbar stabilization system and the Dynesys system. Eur Spine J 2009;18:1504-11.

https://doi.org/10.1007/s00586-009-1077-7

Singhatanadgige W, Tangpornprasert P, Wangroongsub Y, Itiravivong P, Limpaphayom N. A biomechanical cadaveric study of a modified U-shaped interspinous distraction device. J Spinal Disord Tech 2014;27:290-6. https://doi.org/10.1097/BSD.0000000000000049

Downloads

Published

2023-07-19

How to Cite

1.
Hongsaprabhas C, Itiravivong P, Tangpornprasert P, Virulsi C. Effects of modified U-shaped interspinous distraction device on cadaveric intervertebral disc pressure. Chula Med J [Internet]. 2023 Jul. 19 [cited 2024 Dec. 22];65(2). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/126

Issue

Vol. 65 No. 2 (2021): Chulalongkorn Medical Journal

Section

Original Articles

License

Copyright (c) 2023 Chulalongkorn Medical Journal

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Similar Articles

You may also start an advanced similarity search for this article.