Effect of the Total Facet Arthroplasty System after complete laminectomy-facetectomy on the biomechanics of implanted and adjacent segments

Abstract Background context Lumbar fusion is traditionally used to restore stability after wide surgical decompression for spinal stenosis. The Total Facet Arthroplasty System (TFAS) is a motion-restoring implant suggested as an alternative to rigid fixation after complete facetectomy. Purpose To in...

Full description

Saved in:
Bibliographic Details
Published in:The spine journal 2009, Vol.9 (1), p.96-102
Main Authors: Phillips, Frank M., MD, Tzermiadianos, Michael N., MD, Voronov, Leonard I., MD, PhD, Havey, Robert M., BS, Carandang, Gerard, MS, Renner, Susan M., PhD, Rosler, David M., MS, Ochoa, Jorge A., PhD, Patwardhan, Avinash G., PhD
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement - instrumentation
Arthroplasty, Replacement - methods
Biomechanical Phenomena - physiology
Facet arthroplasty
Facetectomy
Female
Humans
Laminectomy - instrumentation
Laminectomy - methods
Lumbar spine
Lumbar Vertebrae
Male
Middle Aged
Orthopedics
Quality of motion
Range of Motion, Articular - physiology
ROM
Spine - surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background context Lumbar fusion is traditionally used to restore stability after wide surgical decompression for spinal stenosis. The Total Facet Arthroplasty System (TFAS) is a motion-restoring implant suggested as an alternative to rigid fixation after complete facetectomy. Purpose To investigate the effect of TFAS on the kinematics of the implanted and adjacent lumbar segments. Study design Biomechanical in vitro study. Methods Nine human lumbar spines (L1 to sacrum) were tested in flexion-extension (+8 to −6 Nm), lateral bending (±6 Nm), and axial rotation (±5 Nm). Flexion-extension was tested under 400 N follower preload. Specimens were tested intact, after complete L3 laminectomy with L3–L4 facetectomy, after L3–L4 pedicle screw fixation, and after L3–L4 TFAS implantation. Range of motion (ROM) was assessed in all tested directions. Neutral zone and stiffness in flexion and extension were calculated to assess quality of motion. Results Complete laminectomy-facetectomy increased L3–L4 ROM compared with intact in flexion-extension (8.7±2.0 degrees to 12.2±3.2 degrees, p
ISSN:1529-9430
1878-1632
DOI:10.1016/j.spinee.2008.01.010