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The effect of posterior compression of the facet joints for initial stability and sagittal profile in the treatment of thoracolumbar fractures: a biomechanical study

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The effect of posterior compression of the facet joints for initial stability and sagittal profile in the treatment of thoracolumbar fractures: a biomechanical study. / Ruf, Michael; Pitzen, Tobias; Nennstiel, Ivo; Volkheimer, David; Drumm, Jörg; Püschel, Klaus; Wilke, Hans-Joachim.

in: EUR SPINE J, Jahrgang 31, Nr. 1, 01.2022, S. 28-36.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Ruf, M, Pitzen, T, Nennstiel, I, Volkheimer, D, Drumm, J, Püschel, K & Wilke, H-J 2022, 'The effect of posterior compression of the facet joints for initial stability and sagittal profile in the treatment of thoracolumbar fractures: a biomechanical study', EUR SPINE J, Jg. 31, Nr. 1, S. 28-36. https://doi.org/10.1007/s00586-021-07034-5

APA

Ruf, M., Pitzen, T., Nennstiel, I., Volkheimer, D., Drumm, J., Püschel, K., & Wilke, H-J. (2022). The effect of posterior compression of the facet joints for initial stability and sagittal profile in the treatment of thoracolumbar fractures: a biomechanical study. EUR SPINE J, 31(1), 28-36. https://doi.org/10.1007/s00586-021-07034-5

Vancouver

Ruf M, Pitzen T, Nennstiel I, Volkheimer D, Drumm J, Püschel K et al. The effect of posterior compression of the facet joints for initial stability and sagittal profile in the treatment of thoracolumbar fractures: a biomechanical study. EUR SPINE J. 2022 Jan;31(1):28-36. https://doi.org/10.1007/s00586-021-07034-5

Bibtex

@article{040a05ef938d471eade6bc02301be6df,
title = "The effect of posterior compression of the facet joints for initial stability and sagittal profile in the treatment of thoracolumbar fractures: a biomechanical study",
abstract = "PURPOSE: Surgical treatment of thoracolumbar A3-fractures usually comprises posterior fixation-in neutral position or distraction-potentially followed by subsequent anterior support. We hypothesized that additional posterior compression in circumferential stabilization may increase stability by locking the facets, and better restore the sagittal profile.METHODS: Burst fractures Type A3 were created in six fresh frozen cadaver spine segments (T12-L2). Testing was performed in a custom-made spinal loading simulator. Loads were applied as pure bending moments of ± 3.75 Nm in all six movement axes. We checked range of motion, neutral zone and Cobb's angle over the injured/treated segment within the following conditions: Intact, fractured, instrumented in neutral alignment, instrumented in distraction, with cage left in posterior distraction, with cage with posterior compression.RESULTS: We found that both types of instrumentation with cage stabilized the segment compared to the fractured state in all motion planes. For flexion/extension and lateral bending, flexibility was decreased even compared to the intact state, however, not in axial rotation, being the most critical movement axis. Additional posterior compression in the presence of a cage significantly decreased flexibility in axial rotation, thus achieving stability comparable to the intact state even in this movement axis. In addition, posterior compression with cage significantly increased lordosis compared to the distracted state.CONCLUSION: Among different surgical modifications tested, circumferential fixation with final posterior compression as the last step resulted in superior stability and improved sagittal alignment. Thus, posterior compression as the last step is recommended in these pathologies.",
keywords = "Animals, Biomechanical Phenomena, Cadaver, Humans, Lumbar Vertebrae/surgery, Range of Motion, Articular, Spinal Fractures/surgery, Zygapophyseal Joint",
author = "Michael Ruf and Tobias Pitzen and Ivo Nennstiel and David Volkheimer and J{\"o}rg Drumm and Klaus P{\"u}schel and Hans-Joachim Wilke",
note = "{\textcopyright} 2021. The Author(s).",
year = "2022",
month = jan,
doi = "10.1007/s00586-021-07034-5",
language = "English",
volume = "31",
pages = "28--36",
journal = "EUR SPINE J",
issn = "0940-6719",
publisher = "Springer",
number = "1",

}

RIS

TY - JOUR

T1 - The effect of posterior compression of the facet joints for initial stability and sagittal profile in the treatment of thoracolumbar fractures: a biomechanical study

AU - Ruf, Michael

AU - Pitzen, Tobias

AU - Nennstiel, Ivo

AU - Volkheimer, David

AU - Drumm, Jörg

AU - Püschel, Klaus

AU - Wilke, Hans-Joachim

N1 - © 2021. The Author(s).

PY - 2022/1

Y1 - 2022/1

N2 - PURPOSE: Surgical treatment of thoracolumbar A3-fractures usually comprises posterior fixation-in neutral position or distraction-potentially followed by subsequent anterior support. We hypothesized that additional posterior compression in circumferential stabilization may increase stability by locking the facets, and better restore the sagittal profile.METHODS: Burst fractures Type A3 were created in six fresh frozen cadaver spine segments (T12-L2). Testing was performed in a custom-made spinal loading simulator. Loads were applied as pure bending moments of ± 3.75 Nm in all six movement axes. We checked range of motion, neutral zone and Cobb's angle over the injured/treated segment within the following conditions: Intact, fractured, instrumented in neutral alignment, instrumented in distraction, with cage left in posterior distraction, with cage with posterior compression.RESULTS: We found that both types of instrumentation with cage stabilized the segment compared to the fractured state in all motion planes. For flexion/extension and lateral bending, flexibility was decreased even compared to the intact state, however, not in axial rotation, being the most critical movement axis. Additional posterior compression in the presence of a cage significantly decreased flexibility in axial rotation, thus achieving stability comparable to the intact state even in this movement axis. In addition, posterior compression with cage significantly increased lordosis compared to the distracted state.CONCLUSION: Among different surgical modifications tested, circumferential fixation with final posterior compression as the last step resulted in superior stability and improved sagittal alignment. Thus, posterior compression as the last step is recommended in these pathologies.

AB - PURPOSE: Surgical treatment of thoracolumbar A3-fractures usually comprises posterior fixation-in neutral position or distraction-potentially followed by subsequent anterior support. We hypothesized that additional posterior compression in circumferential stabilization may increase stability by locking the facets, and better restore the sagittal profile.METHODS: Burst fractures Type A3 were created in six fresh frozen cadaver spine segments (T12-L2). Testing was performed in a custom-made spinal loading simulator. Loads were applied as pure bending moments of ± 3.75 Nm in all six movement axes. We checked range of motion, neutral zone and Cobb's angle over the injured/treated segment within the following conditions: Intact, fractured, instrumented in neutral alignment, instrumented in distraction, with cage left in posterior distraction, with cage with posterior compression.RESULTS: We found that both types of instrumentation with cage stabilized the segment compared to the fractured state in all motion planes. For flexion/extension and lateral bending, flexibility was decreased even compared to the intact state, however, not in axial rotation, being the most critical movement axis. Additional posterior compression in the presence of a cage significantly decreased flexibility in axial rotation, thus achieving stability comparable to the intact state even in this movement axis. In addition, posterior compression with cage significantly increased lordosis compared to the distracted state.CONCLUSION: Among different surgical modifications tested, circumferential fixation with final posterior compression as the last step resulted in superior stability and improved sagittal alignment. Thus, posterior compression as the last step is recommended in these pathologies.

KW - Animals

KW - Biomechanical Phenomena

KW - Cadaver

KW - Humans

KW - Lumbar Vertebrae/surgery

KW - Range of Motion, Articular

KW - Spinal Fractures/surgery

KW - Zygapophyseal Joint

U2 - 10.1007/s00586-021-07034-5

DO - 10.1007/s00586-021-07034-5

M3 - SCORING: Journal article

C2 - 34773149

VL - 31

SP - 28

EP - 36

JO - EUR SPINE J

JF - EUR SPINE J

SN - 0940-6719

IS - 1

ER -