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  • Title: The influence of distraction force on the intradiscal pressure gradient in the bridged lumbar spine: a biomechanical investigation using a calf model.
    Author: Spiegl U, Pätzold R, Glasmacher S, Stephan D, Josten C, Bühren V, Gonschorek O, Augat P.
    Journal: Spine (Phila Pa 1976); 2014 Apr 01; 39(7):E427-33. PubMed ID: 24480960.
    Abstract:
    STUDY DESIGN: A biomechanical calf cadaver study. OBJECTIVE: The purpose of this study was to determine the intradiscal pressure gradient of bridged healthy intervertebral segments in correlation with intraoperative distraction force. SUMMARY OF BACKGROUND DATA: Bisegmental dorsal stabilization and anatomic reduction is a common treatment option for incomplete burst fractures of the lumbar spine. However, it remains unknown to what extent bridging and intraoperative distraction compromises an intact intervertebral disc. METHODS: The L2-L3 intervertebral disc level was evaluated in 6 freshly frozen calf cadaver spines. Pressure measurements were obtained with the spine uninstrumented, after dorsal segmental instrumentation from L1 to L3, and after distraction with 400 N and 800 N. Pressure gradient measurements were accomplished with a balloon pressure sensor placed within the nucleus pulposus of the L2-L3 intervertebral disc. Pressure data were recorded by computer data acquisition. Flexion, extension, and lateral bending moments were applied continuously by a testing machine up to a load moment of 7.5 N·m. The pressure gradients were compared with respect to the effects of added instrumentation and distraction. RESULTS: After segmental bridging the mean pressure gradients were significantly reduced in all movement directions (P < 0.001). However, after dorsal stabilization a continuously rising intervertebral disc pressure was recordable. In contrast, no relevant additional reduction of the intradiscal pressure gradient was detectable after applying distraction forces of 400 N or 800 N. CONCLUSION: In a calf model, a distraction force of up to 800 N leads to no additional reduction of the pressure gradient of bridged healthy lumbar segments under flexion and extension moments.
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