Department of Orthopaedics, General Hospital of Jinan Military Command, 25 Shifan Rd, Jinan, 250031, Shandong, People's Republic of China,
Arch Orthop Trauma Surg. 2014 May;134(5):623-9. doi: 10.1007/s00402-014-1977-9. Epub 2014 Mar 28.
Posterior lumbar interbody fusion (PLIF) and internal fixation are commonly performed for the treatment of lower back pain due to lumbar spinal degeneration. We have developed a novel interspinous fixation device, the interspinous fastener (ISF) for potential use in the surgical management of degenerative spinal disease. The aim of this study was to assess the in vitro biomechanical characteristics of calf lumbar spine specimens after ISF fixation with modified PLIF.
Ten lumbar spine (L3-L6) specimens from ten fresh calf cadavers (8-10 weeks of age) were used. Each specimen underwent sequential testing for each of the following four groups: no instrumentation (INTACT); interspinous fusion device fixation + PLIF (ISF); unilateral pedicle screw and titanium rod fixation + PLIF (UPS); bilateral pedicle screw and titanium rod fixation + PLIF (BPS). Outcome measures included angular range of motion (ROM) during unloaded and loaded (8 Nm) flexion, extension, left bending, right bending, left torsion and right torsion.
For all unloaded and loaded assessments, ROM was significantly higher in the INTACT group compared with all other groups (P < 0.05). Similarly, ROM was significantly higher in the UPS group (indicating decreased stability) compared with the ISF and BPS groups (P < 0.05). The only significant difference between the ISF and BPS groups was in the ROM with unloaded extension (higher in the BPS group, P = 0.006).
We found that ISF fixation with PLIF of the lower lumbar spine provided biomechanical stability that was equivalent to that associated with bilateral pedicle screw/rod fixation with PLIF. The ISF shows potential as an alternative means of fixation in the surgical management of degenerative spinal disease.
后路腰椎体间融合（PLIF）和内固定术常用于治疗因腰椎退变性疾病引起的下腰痛。我们研发了一种新型棘突间固定装置，棘突间紧固件（ISF），有望应用于退行性脊柱疾病的手术治疗。本研究旨在评估 ISF 固定改良 PLIF 后小牛腰椎标本的体外生物力学特性。
10 个新鲜小牛脊柱标本（8-10 周龄）的 L3-L6 段被用于本研究。每个标本都要经过以下 4 组的顺序测试：无器械固定（INTACT）；棘突间融合装置固定+PLIF（ISF）；单侧椎弓根螺钉和钛棒固定+PLIF（UPS）；双侧椎弓根螺钉和钛棒固定+PLIF（BPS）。测量指标包括无负荷和负荷（8Nm）下屈伸、左右侧弯、左右扭转时的活动范围（ROM）。
所有无负荷和负荷评估中，INTACT 组的 ROM 均显著高于其他所有组（P<0.05）。同样，UPS 组（提示稳定性降低）的 ROM 也显著高于 ISF 和 BPS 组（P<0.05）。ISF 和 BPS 组之间仅在无负荷伸展时的 ROM 有显著差异（BPS 组更高，P=0.006）。
我们发现，ISF 固定联合改良 PLIF 固定下腰椎提供了与双侧椎弓根螺钉/棒固定联合 PLIF 相当的生物力学稳定性。ISF 作为退行性脊柱疾病手术治疗中固定方式的一种替代选择具有潜力。
