gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Changes in load distribution due to microsurgical lumbar discectomy

Meeting Abstract

  • Christian Hessler - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany
  • Frank Raimund - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany
  • Michael Morlock - Institut für Biomechanik TUHH, Germany
  • Manfred Westphal - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1654

DOI: 10.3205/10dgnc127, URN: urn:nbn:de:0183-10dgnc1274

Published: September 16, 2010

© 2010 Hessler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Since establishment of microsurgical discectomy in the lumbar spine the majority of surgeons thought that normal anatomy could be saved by using this technique although its´ influence on the kinematic of the facet joint still has not been clarified. The purpose of the present in-vitro-trial was to examine changes in range of motion (ROM) across the facet joint due to microsurgical discectomy without facetotomy.

Methods: Using a spinal loading simulator we simulated physiological flexion, extension, and axial loading in 24 human lumbal functional spinal units (FSU´s). We measured the range of motion across the facet joint in 16 FSU´s before and after surgical intervention using a 3-D-motion measurement system and compared these findings with the results of 8 untreated specimens.

Results: Without discectomy, ROM in the facet joints of L2-L3 FSU´s increased between cycle 100 and cycle 10000 by 0.6% in mean and of L4-L5 by 29.2% in mean. With discectomy after 100 cycles, ROM in the facet joints of L4-L5 FSU´s increased between cycle 100 and cycle 10000 by 5.08% in mean and of L4-L5 by 13.8% in mean.

Conclusions: Despite protection of the facet joints discectomy leads to an increased ROM of the surrounding facet joints. Taken together microsurgical discectomy encompasses a broad set of anatomic changes to the surrounding joints which may result in degenerative changes of the facet joints cartilage and an increased laxity of its´ capsule.