Biomechanical Comparison of Anterior Lumbar Screw-plate Fixation versus Posterior Lumbar Pedicle Screw Fixation

• Published in: Journal of Huazhong University of Science and Technology. Medical sciences Vol. 34; no. 6; pp. 907 - 911
• Main Author: 刘列华 郭从涛 周强 蒲小兵 宋磊 王浩明 赵晨 成仕明 兰阳军 刘岭
• Format: Journal Article
• Language: English
• Published: Heidelberg Huazhong University of Science and Technology 01.12.2014; Department of Orthopedics, Chongqing Dongnan Hospital, Chongqing 401336, China%Department of Orthopedics, Southwest Hospital, Orthopedics Center of PLA,Third Military Medical University,Chongqing 400038,China; Department of Orthopedics, Southwest Hospital, Orthopedics Center of PLA,Third Military Medical University,Chongqing 400038,China
• Subjects: Adult; Bone Plates; Bone Screws; Female; Humans; Lumbar Vertebrae - pathology; Lumbar Vertebrae - physiopathology; Male; Materials Testing; Medicine; Medicine & Public Health; PSF; 力学稳定性; 椎弓根螺钉; 生物力学; 腰椎; 角位移; 轴向压缩; 钉板; anterior lumbar interbody fixation; posterior lumbar interbody fixation; biomechanics
• ISSN: 1672-0733; 1993-1352
• DOI: 10.1007/s11596-014-1372-3

Anterior lumbar interbody fusion （ALiF） followed by posterior pedicle screw fixation （PSF） in a second procedure is mostly used to implement lumbar spine fusion. ALIF followed by an- terior lumbar screw-plate has a lot of advantages, but its biomechanical stability requires confirma- tion. This study evaluated the biomechanical stability of a novel anterior lumbar locked screw-plate （ALLSP） by comparison with posterior lumbar PSF. Twelve fresh human cadaveric lumbar speci- mens （L4-L5） were assigned to four groups： ALIF~PSF group, ALIF＋ALLSP （both fixed） group, ALIF group and an untreated control （both non-fixed） group. The first three groups received implan- tation of a rectangular titanium cage. Tests under axial compression, flexion, extension, lateral bend- ing, or rotation showed that the fixed groups had significantly stronger stability than the non-fixed groups （P=-0.000 for all）. The ALIF＋ALLSP group had significantly greater axial stiffness under ap- plied axial compression and significantly less angular displacement under rotational forces than the ALIF＋PSF group. The angular displacement of the ALIF＋ALLSP group was less under flexion than that of the ALIF＋PSF, and the angular displacement under lateral bending and extension was greater, but these differences were not statistically significant. In summary, the ALLSP conforms to the ante- rior lumbar spine and has good biomechanical stability. It is a reliable choice for enhancing the sta- bility of ALIF.