Journal article
Evaluation of Spinous Process Tethering at the Proximal End of Rigid Constructs: In Vitro Range of Motion and Intradiscal Pressure at Instrumented and Adjacent Levels
INTERNATIONAL JOURNAL OF SPINE SURGERY, v 14(4), pp 571-579
01 Aug 2020
PMID: 32986580
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Adult spinal deformity surgery requires use of long thoracolumbar instrumentation, which is associated with risk of postoperative proximal junctional kyphosis (PJK). Tethering has been used in spinal surgery but not around the spinous process (SP) in the context of preventing PJK. Methods: Researchers applied a nondestructive hybrid loading protocol to 7 T8-L2 cadaveric specimens in flexion-extension, lateral bending, and axial rotation (AR). A rigid construct (pedicle screws and rods) and 1- and 2-level SP constructs were tested, as was a hand-tie technique. SP tethering (SPT) constructs use clamps on both sides of the SP; SPT helix constructs use 1 clamp and wrap around the SP. Results: All tether constructs showed greater motion at the instrumented level and less motion at adjacent levels compared to rigid constructs. In AR, 1- and 2-level SPT constructs restricted first instrumented level motion to a greater extent when compared with other tether constructs (P <= .05). Passing the band through the T10 SP did not produce significant biomechanical differences compared to passing it through the T9-T10 interspinous ligament (P > .05). Hand-tied constructs demonstrated more motion compared to tensioned constructs (P > .05). Intradiscal pressure results corroborated motion data. Conclusions: SPT at the proximal end of a rigid construct produced more favorable biomechanical outcomes at instrumented and adjacent levels than were seen with a completely rigid construct. Clinical research is needed to determine whether these methods reduce the risk of PJK among patients.
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Details
- Title
- Evaluation of Spinous Process Tethering at the Proximal End of Rigid Constructs: In Vitro Range of Motion and Intradiscal Pressure at Instrumented and Adjacent Levels
- Publication Details
- INTERNATIONAL JOURNAL OF SPINE SURGERY, v 14(4), pp 571-579
- Publisher
- INT SOC ADVANCEMENT SPINE SURGERY-ISASS; WHEATON
- Number of pages
- 0
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000564185800017
- Scopus ID
- 2-s2.0-85090948396
- Other Identifier
- 991021860679504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery