Abstract
The Dynesys is a flexible posterior stabilization system that is designed to preserve intersegmental kinematics and reduce loading at the facet joints. The purpose of this study was to determine if the length of the Dynesys spacer has an effect on range of motion (ROM) at the implanted level. Spacer length was found to significantly affect ROM in all three loading directions with and without a follower preload. The longer spacer increased ROM and the shorter spacer decreased ROM, largely due to differences in segmental compression between the two.
The Dynesys, a flexible posterior stabilization system that provides an alternative to fusion, is designed to preserve intersegmental kinematics and alleviate loading at the facet joints. Recent biomechanical evidence suggests that motion with Dynesys is less than the intact spine (Schmoelz, 2003). The purpose of this investigation was to determine if the length of the Dynesys spacer contributes to differences in range of motion (ROM) at the implanted level.
Ten cadaveric lumbar spine segments (L2-L5) were tested by applying a pure moment of ±7.5Nm in three directions of loading with and without a follower preload of 600N. Test conditions included: intact, injury at L3-L4, Dynesys at L3-L4 (standard spacer), long spacer (+2mm), and short spacer (−2mm). Intervertebral rotations were measured using an optoelectronic camera. Pressure sensors placed inside the joint capsules measured facet loads. Statistical significance was determined using repeated measures ANOVA.
Spacer length had a significant effect on ROM in all three loading directions with and without a follower preload. Initial contact loads within the facet joints were 150% and 64% that of the standard spacer for the short and long spacer, respectively.
The magnitude of distraction of the segment affects ROM. Shorter spacers increased segmental compression of the intervertebral disc and facet joints and therefore reduced ROM. With a follower preload, the segment is further compressed and ROM is further reduced.
The results contribute to an understanding of the design of such implants and could help guide future research.
Funding: Synos Foundation, Switzerland, National Science and Engineering Research Council of Canada (NSERC)
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Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
