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- Title
An investigation of range of motion preservation in fusionless anterior double screw and cord constructs for scoliosis correction.
- Authors
Trobisch, Per; Mahoney, Jonathan M.; Eichenlaub, Emily K.; Antonacci, Christopher L.; Cuddihy, Laury; Amin, Dhara B.; Razo-Castaneda, Dominic; Orbach, Mattan R.; McGuckin, Joshua P.; Bucklen, Brandon S.; Antonacci, M. Darryl; Betz, Randal R.
- Abstract
Purpose: To evaluate the motion-preserving properties of vertebral body tethering with varying cord/screw constructs and cord thicknesses in cadaveric thoracolumbar spines. Methods: In vitro flexibility tests were performed on six fresh-frozen human cadaveric spines (T1-L5) (2 M, 4F) with a median age of 63 (59-to-80). An ± 8 Nm load was applied to determine range of motion (ROM) in flexion–extension (FE), lateral bending (LB), and axial rotation (AR) in the thoracic and lumbar spine. Specimens were tested with screws (T5-L4) and without cords. Single (4.0 mm and 5.0 mm) and double (4.0 mm) cord constructs were sequentially tensioned to 100 N and tested: (1) Single 4.0 mm and (2) 5.0 mm cords (T5-T12); (3) Double 4.0 mm cords (T5-12); (4) Single 4.0 mm and (5) 5.0 mm cord (T12-L4); (6) Double 4.0 mm cords (T12-L4). Results: In the thoracic spine (T5-T12), 4.0–5.0 mm single-cord constructs showed slight reductions in FE and 27–33% reductions in LB compared to intact, while double-cord constructs showed reductions of 24% and 40%, respectively. In the lumbar spine (T12-L4), double-cord constructs had greater reductions in FE (24%), LB (74%), and AR (25%) compared to intact, while single-cord constructs exhibited reductions of 2–4%, 68–69%, and 19–20%, respectively. Conclusions: The present biomechanical study found similar motion for 4.0–5.0 mm single-cord constructs and the least motion for double-cord constructs in the thoracic and lumbar spine suggesting that larger diameter 5.0 mm cords may be a more promising motion-preserving option, due to their increased durability compared to smaller cords. Future clinical studies are necessary to determine the impact of these findings on patient outcomes.
- Subjects
RANGE of motion of joints; THORACIC vertebrae; LUMBAR vertebrae; SCOLIOSIS; SCREWS; SPINE
- Publication
European Spine Journal, 2023, Vol 32, Issue 4, p1173
- ISSN
0940-6719
- Publication type
Article
- DOI
10.1007/s00586-023-07608-5