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Cervical total disc replacement maintains segmental motion after posterior decompression
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For same-segment disease, a unilateral foraminotomy can be performed safely, according to researchers.
Michael J. Brody, MD, and colleagues tested eight human cadaveric cervical spines to determine the kinematics of a cervical total disc replacement (TDR) both before and after posterior cervical decompression. The C3–C7 were tested in flexion-extension, lateral bending and axial rotation while intact, after C5–C6 total disc replacement, C5–C6 unilateral foraminotomy, C5–C6 bilateral foraminotomies, and after C5 laminectomy in combination with the bilateral foraminotomies. The researchers obtained moment vs. angular motion curves for each testing step and analyzed load-displacement data to determine the range of angular motion for each step.
The researchers found unilateral foraminotomy did not significantly increase flexion-extension range of movement, nor did it increase range of motion to a greater-than-normal degree. Bilateral foraminotomies were found to increase flexion-extension range of motion; however, motion remained within a physiological range, according to the researchers.
Performing a full laminectomy in the presence of bilateral foraminotomies resulted in significantly increased range of motion but also had the greatest load-displacement curve distortion, which was suggestive of non- physiological motion, according to the researchers.
Brody and colleagues wrote that future disc replacements should account for changes after posterior decompression for same-segment disease.
Disclosure: The authors have no relevant financial disclosures.
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