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The lumbar global fusion - anterior or posterior first?

Dillon, D., Ahuja, S., Evans, Samuel Lewin ORCID:, Holt, Catherine Avril ORCID:, Howes, J. and Davies, P.R. 2002. The lumbar global fusion - anterior or posterior first? Journal of Bone and Joint Surgery (Br) 84-B (SIII) , pp. 329-330.

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Objective: Controversy exists as to whether the biomechanical properties of a 360° lumbar fusion are influenced by the order in which the anterior and posterior components of the procedure are performed. Methods: The fusion technique used Mager screws to effect the posterior fusion and a Syncage implant (Stratec) to effect the anterior component of the fusion. Isolated motion segments from five calf spines were tested in each of two groups. In the first group the posterior fusion was performed first and in the second group the anterior fusion was performed first. Loads were applied as a dead weight of 2Nm in each range of movement of the spine (flexion/extension, lateral flexion and rotation). The range of movement was measured using the Qualisys motion analysis system, using external marker clusters attached to the vertebral bodies. Each motion segment was tested prior to instrumentation, post anterior or posterior instrumentation and with both anterior and posterior instrumentation. Results: Ranges of movement following 360° instrumentation were decreased in all planes. When posterior fixation was performed first; flexion/extension reduced to 55% compared to 26% with anterior fixation first (p=0.020), in lateral flexion 34% v 18% (p=0.382), and in rotation 73% v 18%(p=0.034). Conclusions: The 360° fusion construct has reduced range of movement if the anterior first approach is used as compared to posterior first approach. Posterior fixation should not be performed prior to anterior fixation as this results in a significant loss of stability in both flexion/extension and rotation

Item Type: Article
Date Type: Publication
Status: Published
Schools: Engineering
Subjects: Q Science > QM Human anatomy
T Technology > T Technology (General)
Additional Information: Presented at BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research ,Birmingham UK, 27th February - 1st March 2002.
Publisher: Churchill Livingstone
ISSN: 0301-620X
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Last Modified: 21 Oct 2022 10:40

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