Range of motion in segmental versus nonsegmental ultrahigh molecular weight polyethylene sublaminar wire growth guidance type constructs for early onset scoliosis correction

A.K. Roth, A.J. Veen, van der, R. Bogie, P.C. Willems, B. van Rietbergen, L. Rhijn, van, J.J.C. Arts

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Abstract

Study Design. An in vitro biomechanical study in porcine thoracic spine segments comparing range of motion in segmental versus multiple nonsegmental UHMWPE sublaminar wire constructs. Objective. To determine the effect of varying instrumentation (wire) density in an UHMWPE sublaminar wire construct for early onset scoliosis (EOS) patients in order to find an optimal wire density which allows maximum growth while still providing adequate correction and fixation. Summary of Background Data. UHMWPE sublaminar wires in a segmental construct did not negatively affect longitudinal spinal growth over a 24 week period in an ovine model; application in growth guidance system for EOS may therefore be feasible. In order to avoid ectopic bone formation as much as possible, a reduction of instrumented levels, without affecting spinal stabilization, is desirable. Methods. Range of motion (ROM) of nine porcine thoracic spines (T6-T14) was determined in flexion/extension (FE), lateral bending (LB) and axial rotation (AR) up to +/-4Nm. Tests were performed for the uninstrumented spine, in a segmental construct with UHMWPE sublaminar wires and dual pedicle screws at the most caudal level, and in four nonsegmental constructs which were attained by stepwise removal of the most caudal wire. Results. Segmental instrumentation led to a decrease in total ROM by approximately 70% for both FE and LB. A stepwise increase in ROM with decreasing number of consecutively instrumented levels was most clearly observed in LB. However, consistent significant but also relevant substantial differences in ROM for both FE and LB were noted only when comparing two and one consecutively instrumented end levels (P
Original languageEnglish
Pages (from-to)E1212-E1218
JournalSpine
Volume40
Issue number23
DOIs
Publication statusPublished - Dec 2015

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Keywords

  • Animals
  • Biomechanical Phenomena
  • Bone Wires
  • Models, Biological
  • Polyethylenes
  • Range of Motion, Articular
  • Scoliosis
  • Swine
  • Journal Article
  • Research Support, Non-U.S. Gov't

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