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Intraoperative determination of the load–displacement behavior of scoliotic spinal motion segments: preliminary clinical results

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Abstract

Introduction

Spinal fusion is a widely and successfully performed strategy for the treatment of spinal deformities and degenerative diseases. The general approach has been to stabilize the spine with implants so that a solid bony fusion between the vertebrae can develop. However, new implant designs have emerged that aim at preservation or restoration of the motion of the spinal segment. In addition to static, load sharing principles, these designs also require a profound knowledge of kinematic and dynamic properties to properly characterise the in vivo performance of the implants.

Methods

To address this, an apparatus was developed that enables the intraoperative determination of the load–displacement behavior of spinal motion segments. The apparatus consists of a sensor-equipped distractor to measure the applied force between the transverse processes, and an optoelectronic camera to track the motion of vertebrae and the distractor. In this intraoperative trial, measurements from two patients with adolescent idiopathic scoliosis with right thoracic curves were made at four motion segments each.

Results

At a lateral bending moment of 5 N m, the mean flexibility of all eight motion segments was 0.18 ± 0.08°/N m on the convex side and 0.24 ± 0.11°/N m on the concave side.

Discussion

The results agree with published data obtained from cadaver studies with and without axial preload. Intraoperatively acquired data with this method may serve as an input for mathematical models and contribute to the development of new implants and treatment strategies.

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Acknowledgments

This research has been supported by NCCR Co-Me of the Swiss National Science Foundation.

Conflict of interest

None.

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Authors and Affiliations

  1. Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland

    Christoph Reutlinger & Philippe Büchler

  2. Orthopaedic Department, University Children’s Hospital, Basel, Switzerland

    Carol Hasler

  3. Department of Neuroimaging and MR Physics, Medical Faculty, University of Tübingen, Tübingen, Germany

    Klaus Scheffler

Authors
  1. Christoph Reutlinger
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  2. Carol Hasler
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  3. Klaus Scheffler
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  4. Philippe Büchler
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Correspondence to Christoph Reutlinger.

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Reutlinger, C., Hasler, C., Scheffler, K. et al. Intraoperative determination of the load–displacement behavior of scoliotic spinal motion segments: preliminary clinical results. Eur Spine J 21 (Suppl 6), 860–867 (2012). https://doi.org/10.1007/s00586-012-2164-8

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  • DOI: https://doi.org/10.1007/s00586-012-2164-8

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