Artikel
Lumbar microsurgical discectomy influences the kinematics of the corresponding facet joints
Suche in Medline nach
Autoren
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C. Hessler
- Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
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M. Morlock
- Institut für Biomechanik, Technische Universität Hamburg-Harburg
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M. Westphal
- Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
| Veröffentlicht: | 4. Juni 2012 |
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Gliederung
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Objective: Modern lumbar microsurgical discectomy techniques preserve the spinal bony structures and minimize tissue damage. However, the influence of microsurgical discectomy without facetotomy on the kinematic of the corresponding facet joints is still unclear. The purpose of the present in-vitro study was to examine changes in range of motion across the facet joints during flexion-extension, and axial loading due to microsurgical discectomy without facetotomy.
Methods: Biomechanical testing of 24 lumbal functional spinal units (FSUs) was performed using a hydraulic spine-testing device. 14 FSUs were treated by microsurgical discectomy without facetotomy while 10 FSUs remained untreated. 9.000 cycles of flexion-extension (±5°) with an axial pre-load of 400 N were applied. Range of motion (ROM) of the facet joints was continuously measured using a three-dimensional motion analysis system and was compared between treated and untreated specimens.
Results: Data of 24 FSU's were available for analysis. ROM of the untreated FSU's (n=10) increased by 2.5% (0.07°) in mean. Microsurgical discectomy without facetotomy (n=14) resulted in 11.8% (0.36°) increment in ROM in mean (p<0.05).
Conclusions: Microsurgical discectomy without facetotomy leads to a significantly increased ROM of the corresponding facet joints. In vivo this increased mobility might induce degenerative, inflammatory and molecular processes, which in the long-term possibly contribute to the occurrence of low back pain after surgical intervention.
