TY - JOUR
T1 - The use of interbody cage devices for spinal deformity
T2 - A biomechanical perspective
AU - Cunningham, Bryan W.
AU - Polly, David W.
PY - 2002
Y1 - 2002
N2 - Spinal instrumentation has revolutionized the treatment of spinal deformities and offers a plethora of techniques and designs to surgically treat deformity conditions. The authors address the biomechanical properties afforded by various posterior and anterior spinal instrumentation mechanisms, with and without intervertebral reconstruction, and the principles associated with optimal reconstruction techniques. The integration of multiple strategies can improve anterior and posterior construct stiffness in the treatment of spinal deformities. Structural interbody support probably is the best method to minimize longitudinal rod and screw-bone interface strain. Moreover, anterior load-bearing structural grafts and interbody devices have been shown to increase construct stiffness, decrease the incidence posterior implant failure, permit the use of smaller diameter longitudinal rods, and may enhance the rate of successful spinal arthrodesis. From a biomechanical stand-point, treatment of medium to high-grade spondylolisthesis with stand-alone interbody or transvertebral cages, in the absence of supplemental posterior fixation, is contraindicated. Collectively, the included studies reinforce the principles of load sharing between the anterior and posterior spinal columns and affirm the biomechanical dominance of anterior column support in circumferential spinal arthrodesis.
AB - Spinal instrumentation has revolutionized the treatment of spinal deformities and offers a plethora of techniques and designs to surgically treat deformity conditions. The authors address the biomechanical properties afforded by various posterior and anterior spinal instrumentation mechanisms, with and without intervertebral reconstruction, and the principles associated with optimal reconstruction techniques. The integration of multiple strategies can improve anterior and posterior construct stiffness in the treatment of spinal deformities. Structural interbody support probably is the best method to minimize longitudinal rod and screw-bone interface strain. Moreover, anterior load-bearing structural grafts and interbody devices have been shown to increase construct stiffness, decrease the incidence posterior implant failure, permit the use of smaller diameter longitudinal rods, and may enhance the rate of successful spinal arthrodesis. From a biomechanical stand-point, treatment of medium to high-grade spondylolisthesis with stand-alone interbody or transvertebral cages, in the absence of supplemental posterior fixation, is contraindicated. Collectively, the included studies reinforce the principles of load sharing between the anterior and posterior spinal columns and affirm the biomechanical dominance of anterior column support in circumferential spinal arthrodesis.
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U2 - 10.1097/00003086-200201000-00009
DO - 10.1097/00003086-200201000-00009
M3 - Article
C2 - 11795754
AN - SCOPUS:0036142965
SN - 0009-921X
VL - 394
SP - 73
EP - 83
JO - Clinical orthopaedics and related research
JF - Clinical orthopaedics and related research
ER -