Kinematics of the Cervical Spine Following Discectomy and Stabilization

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Abstract
The immediate blomechanlcal stability of the cervical spine following discectomy and stabilization Is described. Fresh human ligamentous spines (C2-T2) were potted, and clinically relevant loads were applied by a loading frame attached to the C2 vertebra of each specimen. A set of three infrared light-emitting diodes (LEDs) were attached rigidly to each of four vertebrae (C4 to C7) to record their spatial locations after each load step application using a Selspot II (Selcom Selective Electronic, Inc., Valdese, North Carolina) system. The specimen was tested In the intact state, following discectomy at the C5-6 Intervertebral level, following Insertion of a bone graft in the Intervertebral space, and following the application of an anterior metal plate. The load-deformation data of the Injured and stabilized tests were normalized with regard to the corresponding results of the Intact specimens. At the injured level (C5-6), the load-deformation results Indicated a highly significant Increase in motion In flexion (66.6%), extension (69.5%), lateral bending (41.3%), and axial rotation (37.9%). After the insertion of the bone graft, a significant decrease in motion was seen in the effected segment In extension (—45.9%), with similar reductions in lateral bending and axial rotation and a smaller reduction In flexion. The application of an anterior metal plate in addition to the bone graft at the injured level provided significant reduction In motion (-70%) In all load modalities. This data may have clinical relevance regarding the role of Internal fixation In cases of severe spine Instability.

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