A Biomechanical Analysis of Sublaminar and Subtransverse Process Fixation Using Metal Wires and Polyethylene Cables

Fujita, Masatoshi; Diab, Mohammad; Xu, Zheng; Puttlitz, Christian M.

doi:10.1097/01.brs.0000232831.63589.22

Cited by 24 publications

(16 citation statements)

References 28 publications

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“…Removal of a UC by section of the bands is straightforward [29] with no reported complications. Moreover, sublaminar polyethylene bands have been shown to have no adverse interactions with the dura [30] and several other groups have reported clinical use of soft sublaminar bands with no observed complications [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of posterior lumbar dynamic stabilization: an in vitro comparison between Universal Clamp and Wallis systems

et al. 2010

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Treatment of chronic low back pain due to degenerative lumbar spine conditions often involves fusion of the symptomatic level. A known risk of this procedure is accelerated adjacent level degeneration. Motion preservation devices have been designed to provide stabilization to the symptomatic motion segment while preserving some physiologic motion. The aim of this study was to compare the changes in relative range of motion caused as a result of application of two non-fusion, dynamic stabilization devices: the Universal Clamp (UC) and the Wallis device. Nine fresh, frozen human lumbar spines (L1-Sacrum) were tested in flexion-extension, lateral bending, and axial rotation with a custom spine simulator. Specimens were tested in four conditions: (1) intact, (2) the Universal Clamp implanted at L3-4 (UC), (3) the UC with a transverse rod added (UCTR), and (4) the Wallis device implanted at L3-4. Total range of motion at 7.5 N-m was determined for each device and compared to intact condition. The UC device (with or without a transverse rod) restricted motion in all planes more than the Wallis. The greatest restriction was observed in flexion. The neutral position of the L3-4 motion segment shifted toward extension with the UC and UCTR. Motion at the adjacent levels remained similar to that observed in the intact spine for all three constructs. These results suggest that the UC device may be an appropriate dynamic stabilization device for degenerative lumbar disorders.

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Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of posterior lumbar dynamic stabilization: an in vitro comparison between Universal Clamp and Wallis systems

et al. 2010

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“…A possible alternative would be to place the band around the transverse processes instead of the laminae. Subtransverse wiring has already been reported as a safe and effective technique in deformity correction [14][15][16], but the use of subtransverse bands has not been previously reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

Adolescent idiopathic scoliosis correction achieved by posteromedial translation using polyester bands: A comparative study of subtransverse process versus sublaminar fixation

Hirsch

Ilharreborde

Fournier

et al. 2014

Orthopaedics & Traumatology: Surgery & Research

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“…Various soft sublaminar bands have also been proposed as thoracic anchors. They obviate the neurovascular risks associated with screws or wires, provide immediate stability that is lacking with hooks, are anchored around the strongest portion of the neural arch, and apply less stress at any given point on the bony surface than wires, thus reducing the risk of cutout fractures during deformity reduction [25][26][27][28][29]. However, once these bands are tightened, fixation to the fusion rod depends on rudimentary knots, which do not prevent movement up or down the rod.…”

Section: Introductionmentioning

confidence: 99%

Use of the Universal Clamp for deformity correction and as an adjunct to fusion: Preliminary results in scoliosis

Jouve

Gauzy

Blondel

et al. 2010

Journal of Children's Orthopaedics

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Purpose Evaluation of a novel instrumentation device for adolescent idiopathic scoliosis. Methods A new osteosynthesis implant (Universal Clamp) primarily consisting of a sublaminar band and titanium clamp was prospectively studied in 32 patients (average age, 15 years) with a major thoracic curve. Results The Universal Clamp was used without anterior release to reduce and maintain correction of the thoracic curve, which improved from 55.1°preoperatively to 14.5°a t 3 months without neurological complication or loss of kyphosis. Conclusions This implant distributes stress over a larger area of the laminar cortex than sublaminar wires, patently reducing the risk of laminar fracture for equivalent reduction forces, and permits progressive reduction at several apical levels simultaneously.

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A Biomechanical Analysis of Sublaminar and Subtransverse Process Fixation Using Metal Wires and Polyethylene Cables

Abstract: Subtransverse process fixation provides at least as much stability as sublaminar fixation. A 5-mm UHMWPE cable and stainless steel wire result in equivalent sublaminar and subtransverse process stability.

Cited by 24 publications

References 28 publications

Biomechanical evaluation of posterior lumbar dynamic stabilization: an in vitro comparison between Universal Clamp and Wallis systems

Biomechanical evaluation of posterior lumbar dynamic stabilization: an in vitro comparison between Universal Clamp and Wallis systems

Adolescent idiopathic scoliosis correction achieved by posteromedial translation using polyester bands: A comparative study of subtransverse process versus sublaminar fixation

Use of the Universal Clamp for deformity correction and as an adjunct to fusion: Preliminary results in scoliosis

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