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Flexibility of thoracic spines under simultaneous multi-planar loading

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Abstract

Purpose

The corrective potential of two posterior-only destabilization procedures for scoliosis deformity was quantified under single and multi-planar loading using cadaveric spines.

Methods

Ten full-length human cadaveric thoracic spines were mounted in an 8-df servohydraulic load frame. Cyclic, pure moments were applied in: (1) flexion–extension, (2) lateral bending, (3) axial rotation, (4) flexion–extension with axial rotation, and (5) lateral bending with axial rotation at 0.5°/s, to ±4 Nm. Each specimen was tested intact, and again after nine en bloc bilateral total facetectomies, and one, two, three, and four levels of Ponte osteotomies. Motion was measured throughout loading using optical motion tracking.

Results

Under single-plane loading, facetectomies and Ponte osteotomies increased thoracic spine flexibility in all three planes. Compared to total facetectomies, higher per-level increases were seen following Ponte osteotomies, with increases in total range of motion (total ROM) of up to 2.7° in flexion–extension, 1.4° in lateral bending, and 3.1° in axial rotation following each osteotomy. Compared to the facetectomies, four supplemental osteotomies increased total ROM by 23 % in flexion (p < 0.01) and 8 % in axial rotation (p < 0.01). Increases in lateral bending were smaller. Under multi-planar loading, each Ponte osteotomy provided simultaneous increases of up to 1.4°, 1.6°, and 2.2° in flexion–extension, lateral bending, and axial rotation.

Conclusions

Ponte osteotomies provided higher per-level increases in ROM under single-plane loading than total facetectomies alone. Further, Ponte osteotomies provided simultaneous increase in all three planes under multi-planar loading. These results indicated that, to predict the correction potential of a surgical release, multi-planar testing may be necessary.

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Acknowledgments

The study was supported by Doctor’s Education and Research Fund, Orthopaedic Hospital.

Conflict of interest

None.

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Authors and Affiliations

  1. J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, 403 W. Adams Blvd., Los Angeles, CA, 90007, USA

    Sean L. Borkowski, Sophia N. Sangiorgio, Richard E. Bowen, Anthony A. Scaduto, Juliann Kwak & Edward Ebramzadeh

  2. Department of Orthopaedic Surgery, University of California, Los Angeles, USA

    Sophia N. Sangiorgio, Richard E. Bowen, Anthony A. Scaduto, Juliann Kwak & Edward Ebramzadeh

  3. Department of Biomedical Engineering, University of California, Los Angeles, USA

    Sean L. Borkowski

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  1. Sean L. Borkowski
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  2. Sophia N. Sangiorgio
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  3. Richard E. Bowen
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  4. Anthony A. Scaduto
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  5. Juliann Kwak
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  6. Edward Ebramzadeh
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Correspondence to Sophia N. Sangiorgio.

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Borkowski, S.L., Sangiorgio, S.N., Bowen, R.E. et al. Flexibility of thoracic spines under simultaneous multi-planar loading. Eur Spine J 26, 173–180 (2017). https://doi.org/10.1007/s00586-014-3499-0

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  • DOI: https://doi.org/10.1007/s00586-014-3499-0

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