In Vitro Biomechanical Experiment on the Effect of Unilateral Partial Facetectomy Performed by Percutaneous Endoscopy on the Stability of Lumbar Spine.

OBJECTIVES

This study's purpose is to investigate the lumbar biomechanical effects of unilateral partial facetectomy (UPF) of different facet joint (FJ) portions under percutaneous endoscopy.

METHODS

Forty fresh calf spine models were used to simulate UPF under a physiological load performed through three commonly used needle insertion points (IPs): (1) The apex of the superior FJ (as the first IP); (2) The midpoint of the ventral side of the superior FJ (as the second IP); (3) The lowest point of the ventral side of the superior FJ (as the third IP). The range of motion (ROM) and the L4/5 intradiscal maximum pressure (IMP) were measured and analyzed under a physiological load in all models during flexion, extension, left-right lateral flexion, and left-right axial rotation.

RESULTS

When UPF was performed through the second IP, the ROM of the lumbar spine and the L4/5 IMP in the calf spine models were not statistically different from the intact calf spine model.

CONCLUSIONS

UPF through the second IP resulted in a minimal impact on the biomechanics of the lumbar spine. Thus, it might be considered the most appropriate IP for UPF.