Turkish Neurosurgery 2017 , Vol 27 , Num 2
Biomechanical Changes in Disc Pressure and Facet Strain after Lumbar Spinal Arthroplasty with CharitéTM in the Human Cadaveric Spine under Physiologic Compressive Follower Preload
Jong-Il CHOI1,Se-Hoon KIM2,Dong-Jun LIM2,Sung-Kon HA2,Sang-Dae KIM2
1Hallym University Medical Center, Hallym University Kangnam Sacred Heart Hospital, Department of Neurosurgery, Seoul, Korea
2Korea University Medical Center, Department of Neurosurgery, Seoul, Korea
DOI : 10.5137/1019-5149.JTN.15649-15.4 AIM: Arthroplasty maintains the biomechanical features of a healthy disc, decreases the adjacent segment disease rate, and decreases the accelerated degeneration rate of the neighboring discs in traditional fusion procedures. However, there are only a few reports on adjacent disc pressure (DP) and facet strain (FS) after lumbar arthroplasty under a physiologic compressive preload.

MATERIAL and METHODS: Baseline DP and FS measurements were obtained from five intact cadaveric human lumbosacral spines for different modes of motion. DP was measured by inserting pressure transducer needle tips into the L3-L4 and L5-S1 discs. FS gauges were fixed on both sides of the laminae near the L3-L4, L4-L5, and L5-S1 facet joints. After SB CharitéTM III implantation at the L4-L5 level, the measurements were repeated at preload and compared with those of the intact spine.

RESULTS: Under the preload condition, the central DP of the upper disc was decreased during extension and bending, and it significantly increased during rotation (p < 0.05). In the lower disc, the central DP insignificantly decreased during bending and increased during extension and flexion. A statistically significant increase in FS was observed during rotation at the operative facet (p < 0.05). Compared to the intact spine, all FS values were insignificantly decreased during lateral bending but increased during axial rotation.

CONCLUSION: In an ex-vivo physiologic preload setting, the SB CharitéTM III provided relatively inconsistent and sometimes increased DP or FS at the operative and adjacent levels after arthroplasty. Keywords : Biomechanics, Lumbar spinal arthroplasty, CharitéTM, Disc pressure, Facet strain, Physiologic compressive follower preload