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An analysis of adjacent segment motion after lumbar fusion in different sagittal alignments.

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dc.contributor.author김근수-
dc.date.accessioned2015-07-15T17:04:00Z-
dc.date.available2015-07-15T17:04:00Z-
dc.date.issued2003-
dc.identifier.issn0362-2436-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/114158-
dc.description.abstractSTUDY DESIGN: An in vitro biomechanical study of adjacent segment motion (at L3-L4 and L5-S1) after a simulated lumbar interbody fusion of L4-L5 in different sagittal alignments was carried out. OBJECTIVES: To test the hypothesis that an L4-L5 fixation in different sagittal alignments causes increased angular motion at the adjacent levels (L3-L4 and L5-S1) in comparison with the intact spine. SUMMARY OF BACKGROUND DATA: Clinical experience has suggested that lumbar fusion in a nonanatomic sagittal alignment can increase degeneration of the adjacent levels. It has been hypothesized that this is the result of increased motion at these levels; however, to the authors' knowledge no mechanical studies have demonstrated this. METHODS: Eight fresh human cadaveric lumbar spines (L3-S1) were biomechanically tested. Total angular motion at L3-L4 and L5-S1 under flexion-extension load conditions (7-Nm flexion and 7-Nm extension) was measured. Each specimen was tested intact, and then again after each of three different sagittal fixation angles (at L4-L5): (1) in situ (21 degrees lordosis), (2) hyperlordotic (31 degrees lordosis), and (3) hypolordotic (7 degrees lordosis). The simulated anterior/posterior fusion was performed at L4-L5 with pedicle screws posteriorly, vertebral body screws anteriorly, and an interbody dowel. RESULTS: The averaged values for flexion-extension motion at L3-L4 were as follows: intact specimen 2.0 degrees, in situ fixation 4.0 degrees, hyperlordotic fixation 1.7 degrees, hypolordotic fixation 6.5 degrees. The averaged values for flexion-extension motions at L5-S1 were as follows: intact specimen 2.3 degrees, in situ fixation 2.6 degrees, hyperlordotic fixation 3.6 degrees, hypolordotic fixation 2.9 degrees. CONCLUSION: Hypolordotic alignment at L4-L5 caused the greatest amount of flexion-extension motion at L3-L4, and the differences were statistically significant in comparison with intact specimen, in situ fixation, and hyperlordotic fixation. Hyperlordotic alignment at L4-L5 caused the greatest amount of flexion-extension motion at L5-S1, and the difference was statistically significant in comparison with intact specimen but not in situ fixation or hypolordotic fixation.-
dc.description.statementOfResponsibilityopen-
dc.relation.isPartOfSPINE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleAn analysis of adjacent segment motion after lumbar fusion in different sagittal alignments.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Neurosurgery (신경외과학)-
dc.contributor.googleauthorTomoyuki Akamaru-
dc.contributor.googleauthorNorio Kawahara-
dc.contributor.googleauthorWilliam C. Hutton-
dc.contributor.googleauthorKatsuro Tomita-
dc.contributor.googleauthorKeun Su Kim-
dc.contributor.googleauthorAkihito Minamide-
dc.contributor.googleauthorS. Tim Yoon-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA00330-
dc.relation.journalcodeJ02674-
dc.identifier.eissn1528-1159-
dc.identifier.urlhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00007632-200307150-00016&LSLINK=80&D=ovft-
dc.contributor.alternativeNameKim, Keun Su-
dc.contributor.affiliatedAuthorKim, Keun Su-
dc.rights.accessRightsnot free-
dc.citation.volume28-
dc.citation.number14-
dc.citation.startPage1560-
dc.citation.endPage1566-
dc.identifier.bibliographicCitationSPINE, Vol.28(14) : 1560-1566, 2003-
dc.identifier.rimsid52035-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers

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