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Influence of Sequential Ponte Osteotomies on the Human Thoracic Spine With a Rib Cage

  • Biomechanics
  • Published:
Spine Deformity Aims and scope Submit manuscript

Abstract

Study Design

Biomechanical cadaveric study.

Objectives

The purpose of this study was to determine the change in range of motion (ROM) of the human thoracic spine and rib cage due to sequential Ponte osteotomies (POs).

Summary of Background Data

POs are often performed in deformity correction surgeries to provide flexibility in the sagittal plane at an estimated correction potential of 5° per PO, but no studies have evaluated the biomechanical impact of the procedure on a cadaveric model with an intact rib cage.

Methods

Seven human thoracic cadavers with intact rib cages were loaded with pure moments in flexion, extension, axial rotation, and lateral bending for five conditions: intact, PO at T9–T10, PO at T8–T9, PO at T7–T8, and PO at T6–T7. Motion of T1, T6, and T10 were measured, and overall (T1–T12) and regional (T6–T10) ROMs were reported for each mode of bending at each condition.

Results

POs increased ROM in flexion both overall (T1–T12) and regionally (T6–T10), although the magnitude of the increase was marginal (<1°/PO). No significant differences were found in axial rotation or lateral bending.

Conclusions

POs may increase sagittal correction potential before fusion in patients with hyperkyphosis, though more work should be done to determine the magnitude of the changes.

Level of Evidence

Level V.

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Author information

Authors and Affiliations

  1. Department of Mechanical Engineering, University of Kansas, 1530 W 15th St., Learned Hall Room 3138, Lawrence, KS, 66045, USA

    Erin M. Mannen PhD & Elizabeth A. Friis PhD

  2. Department of Neurosurgery, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA

    Paul M. Arnold MD

  3. Department of Orthopaedic Surgery, Children’s Mercy Hospital and Clinics of Kansas City, 2401 Gillham Rd, Kansas City, MO, 64108, USA

    John T. Anderson MD

  4. Bioengineering Graduate Program, University of Kansas, 1450 Jayhawk Blvd, Lawrence, KS, 66045, USA

    Elizabeth A. Friis PhD

Authors
  1. Erin M. Mannen PhD
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  2. Paul M. Arnold MD
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  3. John T. Anderson MD
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  4. Elizabeth A. Friis PhD
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Corresponding author

Correspondence to Elizabeth A. Friis PhD.

Additional information

Author disclosures

EMM (none); PMA (reports other from Z-Plasty, personal fees and other from Medtronic Sofamor Danek, personal fees and other from Stryker Spine, other from AO Spine North America, personal fees and other from Invivo, outside the submitted work); JTA (none); EAF (none).

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Mannen, E.M., Arnold, P.M., Anderson, J.T. et al. Influence of Sequential Ponte Osteotomies on the Human Thoracic Spine With a Rib Cage. Spine Deform 5, 91–96 (2017). https://doi.org/10.1016/j.jspd.2016.10.004

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  • DOI: https://doi.org/10.1016/j.jspd.2016.10.004

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