biomechanical effect of an interlaminar device on ranges of motion, intradiscal pressure, and centers of rotation

Introduction. The IntraSPINE is a new interlaminar device that has been proposed with the aim to decompress the spinal canal without reducing the extension motion. The purpose of this study was therefore to evaluate the biomechanical behavior of L4-L5 spinal units implanted with this interlaminar device, in terms of ranges of motion, intradiscal pressure, and centers of rotation. Material and Methods. Six human lumbar spines were harvested within 10 days after death. A specific spine testing device was used to apply moments up to 10 Nm in flexion-extension, lateral bending (left-right flexion) and left-right axial rotation (torsion), with measurement of vertebral 3D motion and of intervertebral disc pressure. Protocol was repeated for each specimen in 5 configurations: intact specimen; after L4-L5 bilateral medial hemifacetectomy and both yellow ligament resection; after implantation of the interlaminar device at the L4-L5 level; after removal of the L4-L5 supraspinous ligament, resection of the posterior third of the disc and addition of an artificial ligament; after device and artificial ligament removal. Results. The implant reduced increases in segmental flexion seen following injury particularly when applied with the artificial ligament. Intradiscal pressure reduced following application of the implant without reducing extension range. A small posterior shift of the Mean Centers of Rotation (MCR) was noticed after instrumentation. Torsion and lateral bending range was unaffected by the interlaminar device. Conclusion. This biomechanical study yields a better understanding of this interlaminar implant effect. A large clinical trial with follow-up would be required to evaluate and confirm in vivo the observed in vitro biomechanical behavior of the device.