Background Context: Postoperative patient motions are difficult to directly control. Very slow quasistatic motions are intuitively believed to be safer for patients, compared with fast dynamic motions, because the torque on the spine is reduced. Therefore, the outcomes of varying axial rotation (AR) angular loading rate during in vitro testing could expand the understanding of the dynamic behavior and spine response.
Purpose: To observe the effects of the loading rate in AR mechanics of lumbar cadaveric spines via in vitro biomechanical testing.
Study Design: An in vitro biomechanical study in lumbar cadaveric spines.
Methods: Fifteen lumbar cadaveric segments (L1-S1) were tested with varying loading frequencies of AR. Five different frequencies were normalized with the base line frequency (0.125 Hz n=15) in this analysis: 0.05 Hz (n=6), 0.166 Hz (n=6), 0.2 Hz (n=10), 0.25 Hz (n=10), and 0.4 Hz (n=8).
Results: The lowest frequency (0.05 Hz) revealed significant differences (p<.05) for all parameters (torque, passive angular velocity, axial velocity [AV], axial reaction force [RF], and energy loss [EL]) with respect to all other frequencies. Significant differences (p<.05) were observed in the following: torque (0.4 Hz with respect to 0.2 Hz and 0.25 Hz), passive sagittal angular velocity (SAV) (0.4 Hz with respect to all other frequencies; 0.166 Hz with respect to 0.25 Hz), axial linear velocity (0.4 Hz with respect to all other frequencies), and RF (0.4 Hz with respect to 0.2 Hz and 0.25 Hz). Strong correlations (R2>0.75, p<.05) were observed between RF with intradiscal pressure (IDP) and AR angular displacement with IDP. Intradiscal pressure (p<.05) was significantly larger in 0.2 Hz in comparison with 0.125 Hz.
Conclusions: Evidences suggest that measurements at very small frequencies (0.05 Hz) of torque, SAV, AV, RF, and EL are significantly reduced when compared with higher frequencies (0.166 Hz, 0.2 Hz, 0.25 Hz, and 0.4 Hz). Higher frequencies increase torque, RF, passive SAV, and AV. Higher frequencies induce a greater IDP in comparison with lower frequencies.
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http://dx.doi.org/10.1016/j.spinee.2013.11.037 | DOI Listing |
Neurospine
December 2024
Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
This video presents a case of L4-5 unstable spondylolisthesis treated with full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF), emphasizing the GUARD (Glider Used as a Rotary Device) technique for nerve root protection. This innovative approach involves controlled rotation of the cage glider before cage insertion to minimize the risk of nerve root injury, a significant complication in Endo-TLIF procedures. The GUARD technique, validated in previous cadaveric studies, provides enhanced safety during cage insertion by protecting the nerve root.
View Article and Find Full Text PDFFront Bioeng Biotechnol
December 2024
Department of Bioengineering, Imperial College London, London, United Kingdom.
N Am Spine Soc J
December 2024
Department of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Background: Spine surgical training faces increasing challenges due to restricted working hours and greater sub specialization. Modern simulators offer a promising approach to teaching both simple and complex spinal procedures. This study evaluated the acceptance and efficacy of spine simulator training using a lumbar herniated disc model tested by 16 neurosurgical residents (PGY-1-6), and compared 3D and 2D teaching methods.
View Article and Find Full Text PDFBackground: Navigation surgical systems have been widely used in spinal fusion to ensure accuracy and safety during pedicle screw insertion.
Methods: The research was performed under laboratory conditions, using stereotactic navigation, surgical instruments for spinal fusion, development of additional devices and software. During the experiments, all stages of the computed tomography-guided navigation system use were performed-preoperative preparation of patient data and planning to provide visual control of the navigation of surgical instruments during the insertion of screws.
Clin Neurol Neurosurg
December 2024
Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address:
Introduction: Autograft bone is the gold standard graft used in posterolateral lumbar intertransverse fusion (PLF) but can be limited by supply and donor site morbidity. Cadaveric cellular allografts represent an alternative source of graft material that avoids these limitations.
Objective: To assess the safety and efficacy of ViviGenCellular Bone Matrix in comparison to autograft bone in PLF.
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