ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023
The effect of various options for decompression of degenerated lumbar spine motion segments on the range of motion: a biomechanical in vitro study.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Identifying preoperative radiographic metrics to guide surgical selection in lumbar spondylolisthesis and stenosis.North American Spine Society journal · 2025Article
- A narrative review and scoring proposal for secondary lumbar instability after lumbar decompression surgery.Acta neurochirurgica · 2025Review
- Experimental ex vivo characterization of the biomechanical effects of laminectomy and posterior fixation of the lumbo-sacral spine.Scientific reports · 2024Article
- Biomechanical response of decompression alone in lower grade lumbar degenerative spondylolisthesis--A finite element analysis.Journal of orthopaedic surgery and research · 2024Article
- Spinal surgery and the risk of reoperation after total hip arthroplasty: a cohort study based on Swedish spine and hip arthroplasty registers.Acta orthopaedica · 2024Article
- Effect of two-level decompressive procedures on the biomechanics of the lumbo-sacral spine: anFrontiers in bioengineering and biotechnology · 2024Article
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Abstract
backgroundLumbar spinal stenosis is a common disease in the aging population. Decompression surgery represents the treatment standard, however, a risk of segmental destabilization depending on the approach and extent of decompression is discussed. So far, biomechanical studies on techniques were mainly conducted on non-degenerated specimens. This biomechanical in vitro study aimed to investigate the increase in segmental range of motion (ROM) depending on the extent of decompression in degenerated segments.
methodsTen fresh frozen lumbar specimens were embedded in polymethyl methacrylate (PMMA) and loaded in a spine tester with pure moments of ± 7.5 Nm. The specimens were tested in their intact state for lateral bending (LB), flexion/extension (FE) and axial rotation (AR). Subsequently, four different decompression techniques were performed: unilateral interlaminar decompression (DC1), unilateral with "over the top" decompression (DC2), bilateral interlaminar decompression (DC3) and laminectomy (DC4). The ROM of the index segment was reported as percent (%) of the native state.
resultsSpecimens were measured in their intact state prior to decompression. The mean ROM was defined as 100% (FE:6.3 ± 2.3°; LB:5.4 ± 2.8°; AR:3.0 ± 1.6°). Interventions showed a continuous ROM increase: FE (DC1: + 4% ± 4.3; DC2: + 4% ± 4.5; DC3: + 8% ± 8.3;DC4: + 20% ± 15.9), LB(DC1: + 4% ± 6.0; DC2: + 5% ± 7.3; DC3: + 8% ± 8.3; DC4: + 11% ± 9.9), AR (DC1: + 7% ± 6.0; DC2: + 9% ± 7.9; DC3: + 15% ± 11.5; DC4: + 19% ± 10.5). Significant increases in ROM for all motion directions (p < 0.05) were only obtained after complete laminectomy (DC4).
conclusionUnilateral and/or bilateral decompressive surgery resulted in a statistically insignificant ROM increase, whereas complete laminectomy showed statistically significant ROM increase. If this ROM increase also has an impact on the clinical outcome and how to identify segments at risk for secondary lumbar instability should be evaluated in further studies.
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