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An analysis of adjacent segment motion after lumbar fusion in different sagittal alignments.
DC Field | Value | Language |
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dc.contributor.author | 김근수 | - |
dc.date.accessioned | 2015-07-15T17:04:00Z | - |
dc.date.available | 2015-07-15T17:04:00Z | - |
dc.date.issued | 2003 | - |
dc.identifier.issn | 0362-2436 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/114158 | - |
dc.description.abstract | STUDY 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.statementOfResponsibility | open | - |
dc.relation.isPartOf | SPINE | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.title | An analysis of adjacent segment motion after lumbar fusion in different sagittal alignments. | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Neurosurgery (신경외과학) | - |
dc.contributor.googleauthor | Tomoyuki Akamaru | - |
dc.contributor.googleauthor | Norio Kawahara | - |
dc.contributor.googleauthor | William C. Hutton | - |
dc.contributor.googleauthor | Katsuro Tomita | - |
dc.contributor.googleauthor | Keun Su Kim | - |
dc.contributor.googleauthor | Akihito Minamide | - |
dc.contributor.googleauthor | S. Tim Yoon | - |
dc.admin.author | false | - |
dc.admin.mapping | false | - |
dc.contributor.localId | A00330 | - |
dc.relation.journalcode | J02674 | - |
dc.identifier.eissn | 1528-1159 | - |
dc.identifier.url | http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00007632-200307150-00016&LSLINK=80&D=ovft | - |
dc.contributor.alternativeName | Kim, Keun Su | - |
dc.contributor.affiliatedAuthor | Kim, Keun Su | - |
dc.rights.accessRights | not free | - |
dc.citation.volume | 28 | - |
dc.citation.number | 14 | - |
dc.citation.startPage | 1560 | - |
dc.citation.endPage | 1566 | - |
dc.identifier.bibliographicCitation | SPINE, Vol.28(14) : 1560-1566, 2003 | - |
dc.identifier.rimsid | 52035 | - |
dc.type.rims | ART | - |
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