The use of an interspinous implant in conjunction with a graded facetectomy procedure

The range of motion (ROM) of lumbar cadaver spines was measured during flexion, extension, axial rotation, and lateral bending following graded facetectomies and implantation of an X STOP interspinous spacer implant. The study was performed undertaken to understand better the influence of the inters...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2005-06, Vol.30 (11), p.1266-1272
Main Authors: FUCHS, Paul D, LINDSEY, Derek P, HSU, Ken Y, ZUCHERMAN, James F, YERBY, Scott A
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomechanical Phenomena - methods
Cerebrospinal fluid. Meninges. Spinal cord
Endoscopy
Ent
Humans
Injuries of the nervous system and the skull. Diseases due to physical agents
Internal Fixators
Investigative techniques, diagnostic techniques (general aspects)
Lumbar Vertebrae - physiology
Lumbar Vertebrae - surgery
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Pliability
Range of Motion, Articular - physiology
Rotation
Spinal Fusion - instrumentation
Spinal Fusion - methods
Traumas. Diseases due to physical agents
Weight-Bearing
Zygapophyseal Joint - physiology
Zygapophyseal Joint - surgery
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Summary:The range of motion (ROM) of lumbar cadaver spines was measured during flexion, extension, axial rotation, and lateral bending following graded facetectomies and implantation of an X STOP interspinous spacer implant. The study was performed undertaken to understand better the influence of the interspinous spacer implant on the kinematics of the lumbar spine following graded facetectomies. Lateral lumbar spinal stenosis is often treated with a unilateral or bilateral facetectomy procedure. Previous biomechanical research has shown that a facetectomy may increase the ROM during flexion and axial rotation. Seven cadaver spines (L2-L5) were tested in flexion, extension, axial rotation, and lateral bending, and the individual ROM of each motion segment was measured. Specimens were tested intact and following 3 graded facetectomies (i.e., unilateral medial facetectomy [UMF], unilateral total facetectomy [UTF], and bilateral total facetectomy [BTF]), with and without the X STOP. A BTF caused a significant increase in ROM during flexion and axial rotation but not extension and lateral bending. The UMF and UTF did not affect the ROM during any of the 4 motions. The interspinous implant: (1) significantly decreased the flexion ROM for the intact, UMF, UTF, and BTF treatments; (2) significantly decreased the extension ROM for the intact, UMF, and BTF treatments but not the UTF (P < 0.13); (3) had no significant effect on the axial rotation ROM; and (4) significantly increased the lateral bending ROM for the UMF, UTF, and BTF treatments. The results suggest that the implant may be used in conjunction with a UMF or UTF. However, the X STOP should not be used in conjunction with BTF.
ISSN:0362-2436
1528-1159
DOI:10.1097/01.brs.0000164152.32734.d2