Arthroplasty of the Spine pp 130-135 | Cite as
Development and preclinical testing of a new tension-band device for the spine: the Loop system
Abstract
Wire sutures, cerclage constructs, and tension bands have been used for many years in orthopedic surgery. Spinous process and sublam-inar wires and other strands or cables are used in the spine to re-establish stability of the posterior spinal ligament complex. Rigid monofilament wires often fail due to weakening created during twisting or wrapping. Stronger metal cables do not conform well to bony surfaces. Polyethylene cables have higher fatigue strength than metal cables. The Loop cable is a pliable, radiolucent, polyethylene braid. Creep of the Loop/locking clip construct is similar to metal cable constructs using crimps. Both systems have less creep than knotted polyethylene cable constructs.
Keywords
Tension band Spinous process Sublaminar wires Polyethylene cable Creep Fatigue strengthPreview
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References
- 1.Al Baz MO, Mathur N (1995) Modified technique of tension band wiring in flexion injuries of the middle and lower cervical spine. Spine 20:1241–1244PubMedGoogle Scholar
- 2.Allen BL, Ferguson RL (1986) Neurological injuries with the Galveston technique of L-rod instrumentation for scoliosis. Spine 11:14–17PubMedCrossRefGoogle Scholar
- 3.Andersson GBJ, Ortengren R, Nachemson A, et al (1974) Lumbar disc pressure and myoelectric back muscle activity during sitting. I. Studies on an experimental chair. Scand J Rehabil Med 6:104PubMedGoogle Scholar
- 4.Andersson GBJ, Chaffin DB, Pope MH (1991) Occupational biomechanics of the lumbar spine, in occupational low back pain: assessment, treatment, and prevention. Mosby Year Book, St. LouisGoogle Scholar
- 5.Arnold PG, Pairolero PC (1984) Chest wall reconstruction. Experience with 100 consecutive patients. Ann Surg 199:725–732PubMedCrossRefGoogle Scholar
- 6.Bernard TN, Johnston CE, Roberts JM, et al (1983) Late complications due to wire breakage in segmental spinal instrumentation: report of two cases. J Bone Joint Surg Am 65:1339–1345PubMedGoogle Scholar
- 7.Bernard TN, Whitecloud TS, Haddad RJ (1983) Segmental spinal instrumentation in the management of fractures of the thoracolumbar spine: a preliminary report. Orthop Trans 7:227Google Scholar
- 8.Bernhardt A (1993) Tensile testing of UHMWPE Spectra-1000 braid. In: Smith & Nephew Spine Technical Report SP-93-11Google Scholar
- 9.Bernhardt A, Taylor M (1993) Cyclic creep testing of Spectra-1000 braid and titanium cable constructs. In: Smith & Nephew Spine Technical Report SP-93-12Google Scholar
- 10.Boeree NR, Dove J (1993) The selection of wires for sublaminar fixation. Spine 18:497–503PubMedGoogle Scholar
- 11.Brodsky AE, Khalil MA, Sassard WR, et al (1992) Repair of symptomatic pseudoarthrosis of anterior cervical fusion. Posterior versus anterior repair. Spine 17:1137–1143Google Scholar
- 12.Coe JD, Warden KE, Sutterlin CE, et al (1989) Biomechanical evaluation of cervical spinal stabilization methods in human cadaveric model. Spine 14: 1122–1131PubMedCrossRefGoogle Scholar
- 13.Cooper PR (1993) Posterior stabilization of the cervical spine. Clin Neuro-surg 40:286–320Google Scholar
- 14.Cordoso A, Tajonar F, Luque ER (1976) Osteotomy of the spine, new concepts, preliminary report (in Spanish). Anal Orthop Traumatol 12:105–113Google Scholar
- 15.Crawford RJ, Sell PJ, Ali MS, et al (1989) Segmental spinal instrumentation: a study of the mechanical properties of materials used for sublaminar fixation. Spine 14:632–635PubMedCrossRefGoogle Scholar
- 16.Daigle K, Cassidy J, Holbrook J (1992) Fatigue testing of braided Spectra UHMWPE surgical cable. In: Smith & Nephew Orthopedic Research Report OR-92-49Google Scholar
- 17.Davey JR, Rorabeck CH, Bailey SI, et al (1985) A technique of posterior cervical fusion for instability of cervical spine. Spine 10:722–728PubMedCrossRefGoogle Scholar
- 18.Dickman CA, Sonntag VKH (1993) Wire fixation of the cervical spine biomechanical principles and surgical techniques. BNI (Barrow Neurological Institute) Quarterly 9:2–16Google Scholar
- 19.Dickman CA, Papadopoulos SM, Crawford NR, et al (1997) Comparative mechanical properties of spinal cable and wire fixation systems. Spine 22:596–604PubMedCrossRefGoogle Scholar
- 20.Dove J (1989) Segmental wiring for spinal deformity: a morbidity report. Spine 14:229–231PubMedCrossRefGoogle Scholar
- 21.Drummond DS (1999) Segmental spinal instrumentation with spinous process wires. In: An HS, Cotler JM (eds) Spinal instrumentation, 2nd edn. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
- 22.Ferguson RL, Allen BL, Seay GB (1982) The evolution of segmental spinal instrumentation in the treatment of unstable thoracolumbar spine fractures. Orthop Trans 6:346Google Scholar
- 23.Guadagni JR, Drummond DS (1986) Strength of surgical wire fixation: a laboratory study. Clin Orthop 209:176–181PubMedGoogle Scholar
- 24.Hambly M, Lee CK, Gutteling E, et al (1989) Tension band wiring-bone grafting for spondylolysis and spondylolisthesis. Spine 14:455–459PubMedCrossRefGoogle Scholar
- 25.Heller KD, Prescher A, Schneider T, et al (1998) Stability of different wiring techniques in segmental spinal instrumentation. An experimental study. Arch Orthop Trauma Surg 117:96–99PubMedCrossRefGoogle Scholar
- 26.Herzwurm PJ, Walsh J, Pettine KA, et al (1992) Prophylactic cerclage: a method of preventing femur fracture in uncemented total hip arthroplasty. Orthopedics 15:143–146PubMedGoogle Scholar
- 27.Kazarian LE (1972) Dynamic response characteristics of the human vertebral column. Acta Orthop Scand Suppl 146: 1–186Google Scholar
- 28.Lange F (1986) The classic. Support for the spine by means of buried steel bars attached to the vertebrae, by Fritz Lange, 1910. Clin Orthop 203:3–6Google Scholar
- 29.Lange E, Bernhardt A (1994) Construct tensile testing of UHMWPE braid with comparison of titanium cable. In: Smith & Nephew Orthopedic Research Report OP-94-71Google Scholar
- 30.Lee CK, Rosa R, Fernand R (1986) Surgical treatment of tumors of the spine. Spine 11:201–208PubMedCrossRefGoogle Scholar
- 31.Lin PM (1985) Posterior lumbar interbody fusion technique: complications and pitfalls. Clin Orthop 193:90–102PubMedGoogle Scholar
- 32.Lovely TJ, Carl A (1995) Posterior cervical spine fusion with tension-band wiring. J Neurosurg 83:631–635PubMedCrossRefGoogle Scholar
- 33.Luque ER (1982) Segmental spinal instrumentation for correction of scoliosis. Clin Orthop 163:192–198PubMedGoogle Scholar
- 34.Luque E (1986) Segmental spinal instrumentation of the lumbar spine. Clin Orthop 203:126–134PubMedGoogle Scholar
- 35.Luque ER, Cassis, Nelson, et al (1982) Segmental spinal instrumentation in the treatment of fractures of the thoracolumbar spine. Spine 7:312–317PubMedCrossRefGoogle Scholar
- 36.Marras WS (1987) Predictions of forces acting upon the lumbar spine under isometric and isokinetic conditions: a model experiment comparison. Int J Ind Ergonomics 3:19–27CrossRefGoogle Scholar
- 37.Marras WS, Reilly CH (1988) Network of internal trunk loading activities under controlled trunk conditions. Spine 13:661–667PubMedGoogle Scholar
- 38.Martin RJ (1996) SecureStrand Cable System. Neurosurgery 38:842–843PubMedCrossRefGoogle Scholar
- 39.McAfee PC, Bohlman HH, Wilson WL (1985) The triple wire fixation technique for stabilization of acute fracture-dislocations: a biomechanical analysis. Orthop Trans 9:142Google Scholar
- 40.McGill SM (1990) Loads on the lumbar spine and associated tissues. In: Goel VK, Weinstein JN (eds) Biomechanics of the spine: clinical and surgical perspective. CRC Press, Boca Raton, pp 66–94Google Scholar
- 41.McGill SM, Norman RW (1986) Partitioning of the L4–L5 dynamic moment into disc, ligamentous and muscular components during lifting. Spine 11: 666PubMedCrossRefGoogle Scholar
- 42.Morris JM, Lucas DB, Bresler B (1961) Role of the trunk in stability of the spine. J Bone Joint Surg 43:327Google Scholar
- 43.Munson G, Satterlee C, Hammond S, et al (1984) Experimental evaluation of Harrington rod fixation supplemented with sublaminar wires in stabilizing thoracolumbar fracture-dislocations. Clin Orthop 189:97–102PubMedGoogle Scholar
- 44.Mykleburst JB, Pintar F, Yoganandan N, et al (1988) Tensile strength of spinal ligaments. Spine 13:526–531Google Scholar
- 45.Olson SA, Gaines RW (1987) Removal of sublaminar wires after spinal fusion. J Bone Joint Surg Am 69:1419–1423PubMedGoogle Scholar
- 46.Papp T, Porter RW, Aspden RM, et al (1997) An in-vitro study of the biomechanical effects of flexible stabilization on the lumbar spine. Spine 22:151–155PubMedCrossRefGoogle Scholar
- 47.Resina J, Ferreiira-Alvez A (1977) A technique for correction and internal fixation for scoliosis. J Bone Joint Surg Br 5:159–169Google Scholar
- 48.Rhinelander FW, Stewart CL (1983) Experimental fixation of femoral osteotomies by cerclage with nylon straps. Clin Orthop 179:298–307PubMedGoogle Scholar
- 49.Schlegel KF, Pon MA (1985) Biomechanics of posterior lumbar interbody fusion (PLIF) in spondylolisthesis. Clin Orthop 193:115–119PubMedGoogle Scholar
- 50.Schopfer A, Willett K, Powell J, et al (1993) Cerclage wiring in internal fixation of acetabular fractures. J Orthop Trauma 7:236–241PubMedCrossRefGoogle Scholar
- 51.Scuderi GJ, Greenberg SS, Cohen DS, et al (1993) Biomechanical evaluation of magnetic resonance imaging-com-patible wire in cervical spine fixation. Spine 18:1991–1994PubMedCrossRefGoogle Scholar
- 52.Segal D, Whitelaw GP, Gumbs V, et al (1981) Tension band fixation of acute cervical spine fractures. Clin Orthop 159:211–222PubMedGoogle Scholar
- 53.Sheperd DE, Leahy JC, Mathias KJ, et al (2000) Spinous process strength. Spine 25:319–323CrossRefGoogle Scholar
- 54.Songer M (1996) Posterior cervical arthrodesis using the Songer cable system. In: Richard G. Fessler RG, Regis W, Haid RW (eds) Current techniques in spinal stabilization. McGraw-Hill, New YorkGoogle Scholar
- 55.Songer MN (1996) The role of cables in lumbosacral fusion. In: Margulies JY, Floman Y, Farcy JPC, Neuwirth MG (eds) Lumbosacral and spino-pelvic fixation. Lippincott-Raven, PhiladelphiaGoogle Scholar
- 56.Songer MN, Spencer DL, Meyer PR, et al (1991) The use of sublaminar cables to replace luque wires. Spine 16:S418–S421PubMedCrossRefGoogle Scholar
- 57.Stevens SS, Irish AJ, Vachtesevanos JG, et al (1995) A biomechanical study of three wiring techniques for cerclage-plating. J Orthop Trauma 9:381–387PubMedCrossRefGoogle Scholar
- 58.Sullivan JA (1984) Sublaminar wiring of Harrington distraction rods for unstable thoracolumbar spine fractures. Clin Orthop 189:178–185PubMedGoogle Scholar
- 59.Tscherne H, Haas N, Krettek C (1986) Intermedullary nailing combined with cerclage wiring in the treatment of fractures of the femoral shaft. Clin Orthop 212:62–67PubMedGoogle Scholar
- 60.Vaccaro A, Singh K (1999) Principles of spinal instrumentation for cervical spinal trauma. In: An HS, Cotler JM (eds) Spinal instrumentation, 2nd edn. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
- 61.Watts C, Smith H, Knoller N (1993) Risks and cost-effectiveness of sub-laminar wiring in posterior fusion of cervical spine trauma. Surg Neurol 40: 457–460PubMedCrossRefGoogle Scholar
- 62.Weiland DJ, McAfee PC (1991) Posterior cervical fusion with triple-wire strut graft techniques; one hundred consecutive patients. J Spinal Disord 4:15–21PubMedGoogle Scholar
- 63.Weis JC, Cunningham BW, Kanayama M, et al (1996) In vitro biomechanical comparison of multistrand cables with conventional cervical stabilization. Spine 21:2108–2114PubMedCrossRefGoogle Scholar
- 64.Wenger D, Miller S, Wilkerson J (1982) Evaluation of fixation sites for segmental instrumentation of the human vertebrae. Orthop Trans 6:23–24Google Scholar
- 65.Wilson PD, Straub LR (1952) Lumbosacral fusion with metallic-plate fixation. AAOS Instructional Course Lectures, vol IX. JW Edwards, Ann Arbor, pp 53–57Google Scholar
- 66.Wolfe S (2000) Comparative ferrule/tension band system testing. In: Spine-ology Inc. Internal Documents (41-012)Google Scholar
- 67.Wolfe S (2001) The Loop system verification testing. In: Spineology Inc. Internal Documents (41-026)Google Scholar
- 68.Zindrick MR, Knight GW, Bunch WH, et al (1989) Factors influencing the penetration of wires into the neural canal during segmental wiring. Joint Bone Joint Surg Am 71:742–750Google Scholar