BACKGROUND: With increasing advocacy for the use of TDR procedure as a surgical alternative to fusion in the management of lumbar DDD, intradiskal pressures at the adjacent levels of spine have generated considerable interest. The common belief is that adjacent-level disk pressures will be lower after a TDR as opposed to conventional fusion. The aim of this study is to present the effect of different constructs on adjacent-level disk pressures in lumbar spine. We hypothesized that the adjacent-segment disk pressures after 1- and 2-level TDR and/or a fusion-TDR hybrid procedure will show significant variance within physiological range of motion. METHODS: Six adult spine segments T12-S1 with intact ligaments were harvested from cadavers and held firmly in a specially designed fixture. Intradiskal pressures, in motions of flexion, extension, and lateral bending, at L2-L3 and L3-L4 were measured using needle transducers after 2-level TDR L4 through S1, hybrid procedure, and 2-level fusion L4-S1 with femoral ring allograft and pedicle screws. RESULTS: The pressures with lateral bending were not significantly lower than those with flexion and extension at both levels (P = .18). Although TDR and hybrid specimens recorded slightly lower pressures specifically during lateral bending, no statistical difference in pressures could be detected when movements were combined with various procedures. CONCLUSION: Contrary to the assumed hypothesis, the pressures at the adjacent-level disks (L3-4 and L2-3) did not depend upon the stabilization procedure (2-level disk replacement, hybrid, or 2-level fusion) performed after 2-level diskectomy in the lumbosacral spine.
BACKGROUND: With increasing advocacy for the use of TDR procedure as a surgical alternative to fusion in the management of lumbar DDD, intradiskal pressures at the adjacent levels of spine have generated considerable interest. The common belief is that adjacent-level disk pressures will be lower after a TDR as opposed to conventional fusion. The aim of this study is to present the effect of different constructs on adjacent-level disk pressures in lumbar spine. We hypothesized that the adjacent-segment disk pressures after 1- and 2-level TDR and/or a fusion-TDR hybrid procedure will show significant variance within physiological range of motion. METHODS: Six adult spine segments T12-S1 with intact ligaments were harvested from cadavers and held firmly in a specially designed fixture. Intradiskal pressures, in motions of flexion, extension, and lateral bending, at L2-L3 and L3-L4 were measured using needle transducers after 2-level TDR L4 through S1, hybrid procedure, and 2-level fusion L4-S1 with femoral ring allograft and pedicle screws. RESULTS: The pressures with lateral bending were not significantly lower than those with flexion and extension at both levels (P = .18). Although TDR and hybrid specimens recorded slightly lower pressures specifically during lateral bending, no statistical difference in pressures could be detected when movements were combined with various procedures. CONCLUSION: Contrary to the assumed hypothesis, the pressures at the adjacent-level disks (L3-4 and L2-3) did not depend upon the stabilization procedure (2-level disk replacement, hybrid, or 2-level fusion) performed after 2-level diskectomy in the lumbosacral spine.
Authors: Qingan Zhu; Eyal Itshayek; Claire F Jones; Timothy Schwab; Chadwick R Larson; Lawrence G Lenke; Peter A Cripton Journal: Eur Spine J Date: 2012-04-25 Impact factor: 3.134
Authors: Ryan Dimentberg; Saurabh Sinha; Gregory Glauser; Ian F Caplan; James M Schuster; Scott D McClintock; Jang W Yoon; Paul J Marcotte; Zarina S Ali; Neil R Malhotra Journal: Int J Spine Surg Date: 2021-09-22
Authors: Joep Kitzen; Timon F G Vercoulen; Martijn G M Schotanus; Sander M J van Kuijk; Nanne P Kort; Lodewijk W van Rhijn; Paul C P H Willems Journal: Global Spine J Date: 2020-07-02