《Hybrid multidirectional test method to evaluate spinal adjacent-level effects》.pdfVIP

Clinical Biomechanics 22 (2007) 257–265 /locate/clinbiomech Hybrid multidirectional test method to evaluate spinal adjacent-level effects Manohar M. Panjabi Biomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, P.O. Box 208071, New Haven, CT 06520-8071, USA Received 2 February 2006; accepted 23 August 2006 Abstract Background. Several clinical studies have documented long-term adjacent-level effects of spinal fusion, due to stress concentration and motion loss at the fused segment. Non-fusion motion preservation devices are designed to eliminate or slow down such adverse effects. Therefore, appropriate biomechanical evaluation of the adjacent-level effects in spine is important and timely. Although many biome- chanical studies are available and have provided some understanding of the adjacent-level effects, results have large variation and are conflicting, mostly due to the use of inappropriate and ill-defined methods. A new test method especially designed to study spinal adja- cent-level effects is needed. Methods. The proposed Hybrid method uses unconstrained pure moment to provide rotation-input for multi-directional testing. The new method has four steps: (1) Intact spine specimen with entire mobile region is used. The specimen is prepared to measure various biomechanical parameters, e.g., disc pressures, ligament strains, and facet loads. (2) Appropriate unconstrained pure moment is applied to the intact specimen and total range of motion is determined. (3) Unconstrained pure moment i