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Analysis and Prevention of Spinal Column Deformity Following Cervical Laminectomy IPathogenetic Analysis of Postlaminectomy Deformities

 

作者: TETSUFUMI SAITO,   TAKAO YAMAMURO,   JITSUHIKO SHIKATA,   MASANORI OKA,   SADAMI TSUTSUMI,  

 

期刊: Spine  (OVID Available online 1991)
卷期: Volume 16, issue 5  

页码: 494-502

 

ISSN:0362-2436

 

年代: 1991

 

出版商: OVID

 

关键词: cervical spine laminectomy;postoperative deformity

 

数据来源: OVID

 

摘要:

Postlaminectomy deformities were simulated in the cervical or cervicothoracic spine by the use of a displacement incremental method based on finite-element analysis combined with composite material and spanning element theory. The simulation analyses revealed that the primary cause of postlaminectomy deformity was the resection of one or more spinous processes and/or posterior ligaments (ie, ligamenta flava, supraspinous, and interspinous ligaments). After their removal, the tensile stresses that were preoperatively distributed through the posterior ligaments were transferred to the facets. This led to an imbalance of the stresses on the spinal bodies, causing deformity. The gravitational center of the head determined whether the deformity would develop as a kyphosis or increasing lordosis. As the elastic modulus of the soft tissue composites (eg, end plates, ligaments, and facets) increased, a kyphotic deformity changed gradually from swan-neck deformity, to extreme kyphotic deformity with a large curvature, and finally to a straightening deformity. Progressive kyphotic deformity is found only in children.

 

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