gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Biomechanical testing of cervical spine stability after ventral uncoforaminotomy

Biomechanische Testung der zervikalen Stabilität nach ventraler Uncoforaminotomie

Meeting Abstract

  • corresponding author K. Schmieder - Department of Neurosurgery, Ruhr-University Bochum, Bochum
  • A. Kettner - Institute for Traumatological Research and Biomechanics, University of Ulm, Ulm
  • C. Brenke - Department of Neurosurgery, Ruhr-University Bochum, Bochum
  • I. Pechlivanis - Department of Neurosurgery, Ruhr-University Bochum, Bochum
  • A. Harders - Department of Neurosurgery, Ruhr-University Bochum, Bochum
  • H. J. Wilke - Institute for Traumatological Research and Biomechanics, University of Ulm, Ulm

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-10.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0043.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Schmieder et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Degenerative spinal disorders are currently treated with ventral discectomy followed by fusion. Ventral uncoforaminotomy was proposed as an alternative technique by Jho. Main advantage of this technique as a non-fusion strategy is the intact motion segment postoperatively. The aim of this study was to evaluate the changes following this surgical procedure in regard to stability.

Methods

3 human cervical spine specimens were tested biomechanically in a special developed spine tester. The tested motion segments were C4/5 and C6/7 in every specimen. The lower part of the segment was fixed rigidly in the tester whereas the upper part was fixed in a gimbal with integrated stepper motors. Only pure moments were used for flexion/extension, axial rotation and lateral bending. Starting from a neutral position three continuous cycles were performed for each axis. Each run was performed with 10N axial preload. After the first run uncoforaminotomy on the right side was done. Then the second test was performed followed by an uncoforaminotomy on the left side. The next test was done thereafter. For each specimen the third cycle was plotted in a load-deformation curve and the range of motion (ROM) and the neutral zone (NZ) were calculated. Furthermore, normation with the presurgical status was done and the results were calculated as a percentage of change.

Results

After unilateral uncoforaminotomy on the right side ROM and NZ increased significantly during lateral bending to the left side. Flexion but not Extension showed the same significant increase in ROM and NZ. Furthermore, during rotation to the left side ROM and NZ were also significantly increased. After bilateral uncoforaminotomy both parameters showed a further significant increase this time during rotation in both directions. After bilateral uncoforaminotomy additonal changes in ROM and NZ during lateral bending and flexion/extension were detectable but not as pronounced as the ones during rotation.

Conclusions

Following unilateral uncoforaminotomy a significant alteration of stability of the segment is found especially during rotation and less pronounced during lateral bending and flexion. Influence on extension is marginal. The additional increase in instability after bilateral uncoforaminotomy is also mainly found during rotation. According to the current data bilateral uncoforaminotomy can not be recommended in the treatment of degenerative disc disease.