• Spine · Jun 2009

    Biomechanical analysis of a disc prosthesis distal to a scoliosis model.

    • Martin Quirno, Jonathan R Kamerlink, Antonio Valdevit, Matthew Kang, Burt Yaszay, Naphysah Duncan, Oheneba Boachie-Adjei, Baron S Lonner, and Thomas J Errico.
    • NYU Hospital for Joint Diseases, New York, NY 10016, USA.
    • Spine. 2009 Jun 15; 34 (14): 1470-5.

    Study DesignBiomechanical study of bovine spines.ObjectiveThe purpose of this study was to perform a biomechanical test to analyze intervertebral deflections following placement of both 1 and 2 semiconstrained TDRs in the subjacent segments of a long fusion.Summary Of Background DataLong-term sequela of long lumbar fusion for scoliosis include adjacent segment disease and flatback syndrome. Total disc replacement (TDR) is a viable option for the treatment of these conditions. Little data has been published regarding the placement of a TDR distal to a scoliosis fusion.MethodsSix thoracolumbar bovine spines (T12-S1) were instrumented from T12 to L5, with bilateral pedicle screw fixation at each level. L5-L6 and L6-S1 served as the test levels. One TDR (FlexiCore, Stryker Spine, Allendale, NJ) was initially performed adjacent to the fusion, followed by a subsequent TDR insertion at the last spinal segment. The applied load, total specimen deflection, and local transducer deflections were recorded before and after a TDR at both levels. The results were expressed as a percentage of the intact specimen. Flexion, extension, lateral bending, and torsional deflections were recorded.ResultsThere were no significant differences (P > 0.05) in sensor deflection observed at the L5-L6 and L6-S1 levels in the anterior and lateral transducers when compared to intact spines specimens. A similar effect was observed at the L5-L6 and L6-S1 levels in the anterior and lateral transducers when compared to intact or prior L5-L6 and intact L6-S1 constructs.ConclusionThis study has shown that using the FlexiCore system at 1 and/or 2 intervertebral disc spaces caudal to a scoliosis fusion model did not significantly change the sensor deflection at the 2 segments adjacent to a scoliosis fusion construct. Future research will continue to define the clinical setting and patients best suited for management by TDR systems.

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