Johnson Wesley M, Nichols Tann A, Jethwani Deepika, Guiot Bernard H
Spine Biomechanics Laboratory, Department of Neurological Surgery, University of South Florida, Tampa, Florida 33606, USA.
J Neurosurg Spine. 2007 Sep;7(3):332-5. doi: 10.3171/SPI-07/09/332.
Anterior lumbar interbody fusion (ALIF) is often supplemented with instrumentation to increase stability in the spine. If anterior plate fixation provided the same stability as posterior pedicle screw fixation (PSF), then a second approach and its associated morbidity could be avoided.
Seven human cadaveric L4-5 spinal segments were tested under three conditions: ALIF with an anterior plate, ALIF with an anterolateral plate, and ALIF supplemented by PSF. Range of motion (ROM) was calculated for flexion/extension, lateral bending, and axial torsion and compared among the three configurations.
There were no significant differences in ROM during flexion/extension, lateral bending, or axial torsion among any of the three instrumentation configurations.
The addition of an anterior plate or posterior PS/rod instrumentation following ALIF provides substantially equivalent biomechanical stability. Additionally, the position of the plate system, either anterior or anterolateral, does not significantly affect the stability gained.
腰椎前路椎间融合术（ALIF）通常需辅以器械固定以增强脊柱稳定性。若前路钢板固定能提供与后路椎弓根螺钉固定（PSF）相同的稳定性，那么可避免二次手术及其相关并发症。
对7个保存于甲醛中的人体L4 - 5脊柱节段在三种情况下进行测试：单纯前路钢板固定的ALIF、前路外侧钢板固定的ALIF以及联合PSF的ALIF。计算屈伸、侧屈和轴向扭转时的活动范围（ROM），并对三种固定方式进行比较。
三种固定方式在屈伸、侧屈或轴向扭转时的ROM均无显著差异。
ALIF术后增加前路钢板或后路PS/棒固定提供了基本相当的生物力学稳定性。此外，钢板系统位于前方或前外侧对获得的稳定性并无显著影响。
