科研之友
微信
新浪微博
Facebook
分享链接
摘要
Object. Lumbar spinal stenosis (LSS) may lead to disabling neurogenic symptoms and has traditionally been treated using open laminectomy. A new technique for correcting LSS involves lengthening the lumbar pedicles through bilateral percutaneous pedicle osteotomies. In this paper, the authors%26apos; goal was to evaluate the changes in spinal canal dimensions and kinematic behavior after pedicle-lengthening osteotomies. %26lt;br%26gt;Methods. The kinematic behavior of 8 cadaveric lumbar segments was evaluated intact and after bilateral pedicle-lengthening osteotomies at the L-4, L-5, and L-4 and L-5 levels. Testing was conducted with and without a compressive preload using a custom kinematic apparatus that allowed for 3D tracking of each vertebra during flexion-extension, right-left bending, and right-left rotation. A validated finite element (FE) spine model was used to measure the changes in the cross-sectional area of the spinal canal and neural foramen after 2-, 3-, and 4.5-mm simulated pedicle-lengthening osteotomy procedures. %26lt;br%26gt;Results. The overall and segmental kinematics were not significantly altered after the pedicle-lengthening osteotomy procedure at the L-4 and/or L-5 pedicles. The kinematic signatures of the intact and lengthened states were similar for all motion pairs. The FE spine model yielded kinematics predictions within or close to the 95% confidence interval for the cadaveric data. The FE spine demonstrated substantial, pedicle length-dependent enlargement of the cross-sectional areas of the spinal canal and neural foramen after simulated pedicle lengthening. %26lt;br%26gt;Conclusions. Bilateral pedicle-lengthening osteotomies produced substantial increases in the cross-sectional areas of the spinal canal and neural foramen without significantly altering normal spinal kinematics. This technique deserves further study as a less invasive treatment option for LSS. (http://thejns.org/doi/abs/10.3171/2012.6.SPINE11518)
- 出版日期2012-10
