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Yue J, Han Q, Chen H, Zhang A, Liu Y, Gong X, Wang Y, Wang J, Wu M. Artificial lamina after laminectomy: Progress, applications, and future perspectives. Front Surg 2023; 10:1019410. [PMID: 36816003 PMCID: PMC9932198 DOI: 10.3389/fsurg.2023.1019410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023] Open
Abstract
In clinical practice, laminectomy is a commonly used procedure for spinal decompression in patients suffering from spinal disorders such as ossification of ligamentum flavum, lumbar stenosis, severe spinal fracture, and intraspinal tumors. However, the loss of posterior column bony support, the extensive proliferation of fibroblasts and scar formation after laminectomy, and other complications (such as postoperative epidural fibrosis and iatrogenic instability) may cause new symptoms requiring revision surgery. Implantation of an artificial lamina prosthesis is one of the most important methods to avoid post-laminectomy complications. Artificial lamina is a type of synthetic lamina tissue made of various materials and shapes designed to replace the resected autologous lamina. Artificial laminae can provide a barrier between the dural sac and posterior soft tissues to prevent postoperative epidural fibrosis and paravertebral muscle compression and provide mechanical support to maintain spinal alignment. In this paper, we briefly review the complications of laminectomy and the necessity of artificial lamina, then we review various artificial laminae from clinical practice and laboratory research perspectives. Based on a combination of additive manufacturing technology and finite element analysis for spine surgery, we propose a new designing perspective of artificial lamina for potential use in clinical practice.
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Affiliation(s)
- Jing Yue
- Department of Anesthesiology, The Second Hospital of Jilin University, Changchun, China
| | - Qing Han
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Hao Chen
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Aobo Zhang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Yang Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Xuqiang Gong
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Yang Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China,Correspondence: Minfei Wu Jincheng Wang
| | - Minfei Wu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China,Correspondence: Minfei Wu Jincheng Wang
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Iatrogenic Spondylolisthesis Following Open Lumbar Laminectomy: Case Series and Review of the Literature. World Neurosurg 2018; 113:e383-e390. [DOI: 10.1016/j.wneu.2018.02.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/05/2018] [Accepted: 02/06/2018] [Indexed: 12/11/2022]
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Chamoli U, Korkusuz MH, Sabnis AB, Manolescu AR, Tsafnat N, Diwan AD. Global and segmental kinematic changes following sequential resection of posterior osteoligamentous structures in the lumbar spine: An in vitro biomechanical investigation using pure moment testing protocols. Proc Inst Mech Eng H 2016; 229:812-21. [PMID: 26503842 DOI: 10.1177/0954411915612503] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Lumbar spinal surgeries may compromise the integrity of posterior osteoligamentous structures implicating mechanical stability. Circumstances necessitating a concomitant surgery to achieve restabilisation are not well understood. The main objective of this in vitro study was to quantify global and segmental (index and adjacent levels) kinematic changes in the lumbar spine following sequential resection of the posterior osteoligamentous structures using pure moment testing protocols. Six fresh frozen cadaveric kangaroo lumbar spines (T12-S1) were tested under a bending moment in flexion-extension, bilateral bending, and axial torsion in a 6-degree-of-freedom Kinematic Spine Simulator. Specimens were tested in the following order: intact state (D0), after interspinous and supraspinous ligaments transection between L4 and L5 (D1), further after a total bilateral facetectomy between L4 and L5 (D2). Segmental motions at the cephalad, damaged, and caudal levels were recorded using an infrared-based motion tracking device. Following D1, no significant change in the global range of motion was observed in any of the bending planes. Following D2, a significant increase in the global range of motion from the baseline (D0) was observed in axial torsion (median normalised change +20%). At the damaged level, D2 resulted in a significant increase in the segmental range of motion in flexion-extension (+77%) and axial torsion (+492%). Additionally, a significant decrease in the segmental range of motion in axial torsion (-35%) was observed at the caudal level following D2. These results suggest that a multi-segment lumbar spine acts as a mechanism for transmitting motions, and that a compromised joint may significantly alter motion transfer to adjacent segments. We conclude that the interspinous and supraspinous ligaments play a modest role in restricting global spinal motions within physiologic limits. Following interspinous and supraspinous ligaments transection, a total bilateral facetectomy resulted in a significant increase in axial torsion motion, both at global and damaged levels, accompanied with a compensatory decrease in motion at the caudal level.
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Affiliation(s)
- Uphar Chamoli
- Spine Service, Department of Orthopaedic Surgery, St George & Sutherland Clinical School, University of New South Wales Australia, Sydney, NSW, Australia School of Mechanical and Manufacturing Engineering, University of New South Wales Australia, Sydney, NSW, Australia
| | - Mert H Korkusuz
- Spine Service, Department of Orthopaedic Surgery, St George & Sutherland Clinical School, University of New South Wales Australia, Sydney, NSW, Australia
| | - Ashutosh B Sabnis
- Spine Service, Department of Orthopaedic Surgery, St George & Sutherland Clinical School, University of New South Wales Australia, Sydney, NSW, Australia
| | - Andrei R Manolescu
- Spine Service, Department of Orthopaedic Surgery, St George & Sutherland Clinical School, University of New South Wales Australia, Sydney, NSW, Australia
| | - Naomi Tsafnat
- School of Mechanical and Manufacturing Engineering, University of New South Wales Australia, Sydney, NSW, Australia
| | - Ashish D Diwan
- Spine Service, Department of Orthopaedic Surgery, St George & Sutherland Clinical School, University of New South Wales Australia, Sydney, NSW, Australia
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