Effects of Anterior Vertebral Grafting on the Traumatized Lumbar Spine After Pedicle Screw-Plate Fixation

Abstract

This study was conducted to determine the effects of corpectomy and anterior strut grafting on the biomechanics of traumatized lumbar spine after pedicle screw-plate fixation. Eight lumbar spines were loaded until fracture (initial cycle) and then reloaded to the same deformation (injury cycle). After transpedicular fixation, spines were again loaded (fixation cycle). Partial corpectomy of the fractured body and anterior strut grafting were accomplished; the spine reloaded (strut cycle). Spine angles were measured and biomechanical strength and kinematic parameters analyzed. Load-deformation relationships were similar for fixation and strut cycles until maximum load; at failure, loads were higher for the former (P < 0.05), however. Alignment was improved by stabilization or stabilization plus anterior grafting (P < 0.05). Vertebral height was best maintained by grafting as an adjunct to pedicle fixation (P < 0.05). Kinematics were largely unaffected by grafting, except for reduced motion at the posterior vertebral targets between the fixated levels (P < 0.05). The strength of the fixated spine is relatively unchanged by corpectomy and anterior grafting; alignment may be improved in the latter group.