Voor M J, Mehta S, Wang M, Zhang Y M, Mahan J, Johnson J R
Department of Orthopaedic Surgery, University of Louisville School of Medicine, Kentucky 40292, USA.
J Spinal Disord. 1998 Aug;11(4):328-34.
This study determined the biomechanical differences between anterior and posterior lumbar interbody fusion (ALIF and PLIF). Ten cadaveric spines were tested. Five specimens had ALIF and five had PLIF at L4-L5. Stabilization was performed with pedicle screws and rods (Cotrel-Dubboset, Sofamor-Danek, Memphis, TN, U.S.A.). Angular motion was measured in flexion, extension, bending, and torsion on the intact, instrumented, and "fused" specimens. Instrumentation alone caused a significant decrease in segmental motion in all loading modes (p < 0.01). After the simulated fusion procedures, all specimens were most stable in flexion, and significantly less stable in extension (p = 0.04). Comparing directly, ALIF was significant more stable in left torsion (p = 0.03) with trends in left bending (p = 0.08) and right torsion (p = 0.07). Thus, from a purely biomechanical perspective, ALIF appears to be slightly superior to PLIF.
本研究确定了腰椎前路椎间融合术（ALIF）和后路椎间融合术（PLIF）之间的生物力学差异。对10具尸体脊柱进行了测试。5个标本在L4-L5节段进行了ALIF，5个标本进行了PLIF。使用椎弓根螺钉和棒（Cotrel-Dubboset，Sofamor-Danek，美国田纳西州孟菲斯）进行固定。在完整、固定和“融合”标本上测量了屈伸、侧弯和扭转时的角运动。仅固定器械就导致所有加载模式下节段运动显著减少（p<0.01）。在模拟融合手术后，所有标本在屈曲时最稳定，而在伸展时稳定性显著降低（p=0.04）。直接比较发现，ALIF在左旋时稳定性显著更高（p=0.03），在左侧弯（p=0.08）和右旋（p=0.07）时也有类似趋势。因此，从纯粹的生物力学角度来看，ALIF似乎略优于PLIF。
