ArticleJournal of clinical orthopaedics and trauma2025
Facet joint loading after Kevlar-reinforced disc replacement vs. lumbar fusion. A cadaveric model study.
Article in Journal of clinical orthopaedics and trauma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: Lumbar spinal fusion, while effective for degenerative disc disease, eliminates motion and may accelerate adjacent segment degeneration. Total disc replacement (TDR) with anterior annular reinforcement may offer a motion-preserving alternative. Objective: To compare spinal kinematics and facet joint pressures between (1) total lumbar disc replacement with anterior Kevlar band reinforcement (TDR group) and (2) standard 360° lumbar fusion (fusion group) in a cadaveric model. Methods: Six fresh-frozen human lumbar spines (L2-S1) were tested in a custom motion simulator under both surgical conditions at L4-L5. Kinematic parameters included range of motion (ROM), peak angles, and motion harmony (angle-acceleration correlation). Zygapophyseal joint pressures were measured using Tekscan sensors. Data were analyzed using repeated-measures ANOVA. Results: The TDR group preserved significantly greater flexion (-25.7° vs -21.8°, Conclusion: Anterior annular reconstruction with Kevlar bands during total disc replacement restores near-physiological motion and improves kinematic control without increasing facet joint stress. This technique may offer a biomechanically favorable alternative to lumbar fusion.
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