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European Spine Journal

, Volume 7, Issue 3, pp 229–238 | Cite as

Laminectomy and functional impairment of the lumbar spine: the importance of muscle forces in flexible and rigid instrumented stabilization – a biomechanical study in vitro

  • U. Quint
  • H.-J. Wilke
  • F. Löer
  • L. Claes
Original article

Abstract

Laminectomy is the accepted treatment for spinal canal stenosis in cases where conservative treatment has failed. Opinions diverge on the resulting clinical instability and the necessity of instrumented stabilization. The present biomechanical study was performed to determine the functional impairment following laminectomy and the stabilizing effect of flexible and rigid devices. This was the first time that the effects of agonist and antagonist intersegmental lumbar muscle forces acting on intact, unstable and instrumentally stabilized functional spinal units have been investigated. Six human cadaveric lumbar spines were tested in a spine tester. The coactivation of agonist and antagonist muscle forces resulted in increased stability under the load conditions of bending and rotation; a slight increase in the range of motion was noted during flexion. The functional impairment following laminectomy was corrected by ligamentoplasty and by means of muscle forces. Ligamentoplasty appears to be an alternative to decompression with spondylodesis, especially in patients with well-developed muscles.

Key words Spinal biomechanics Intersegmental muscle forces Operative decompression Instrumented stabilization 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • U. Quint
    • 1
  • H.-J. Wilke
    • 2
  • F. Löer
    • 1
  • L. Claes
    • 2
  1. 1.Orthopaedic Clinic University of Essen, Hufelandstrasse 55, D-45 122 Essen, Germany Tel. +49 201 4089 261 Fax +49 201 494833 e-mail tok030@sp2.power.uni-essen.deGermany
  2. 2.Department of Trauma and Biomechanics, University of Ulm, Ulm, GermanyGermany

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