![]() ![]() No significant motion changes after laminectomy alone or after resection of 25% or 50% of the facet.FLX and AR increase after 75% or 100% facetectomy.Horizontal motion increases after removal of facet joint.EXT increases with disruption of all anterior ligaments.FLX increases with disruption of all posterior structures.In adults, laminectomy is not frequent, and it does not produce significant motion increase (biomechanical study).Įffect of Partial or Total Facetectomy(Biomechanical Studies of the Cervical Spine).Common complications of laminectomy: Development of kyphosis, instability and inadequate decompression.Posterior Approach: Laminectomy and Foraminotomy.In case of single level surgery, the interbody grafting is sufficient for maintaining segmental stability if the posterior elements are intact.Reconstruction with an interbody graft.Anterior approach: Discectomy or Corpectomy.Vertebrectomy makes the spine unstable, and the fusion and instrumentation is recommended. ![]() The vertebral body is completely removed (vertebrectomy) in most cases.Clinical evidence is not as evident as biomechanical studies.Įffect of Decompression in the Thoracic Spine.Bilateral laminectomy and facetectomy also increases the FLX and AR motions.Additional removal of total NP increases rotational motions in all directions compared to the intact case.FLX, AR and LB motion increased in the presence of uni-lateral partial facetectomy & facetectomy.Total facetectomy (uni- or bi-lateral) created significant motion increase in FLX and AR.FLX increases with uni- and bilateral medial facetectomy with division of supra- and inter-transverse ligaments.Abumi et al.: Effect of graded facetectomy.Partial discectomy: simulated by removing small amount of NP in addition to partial AF removalĮffect of Laminectomy & Facetectomy in the Lumbar Spine.Disc herniation (or protrusion): simulated by cutting the posterolateral part of the AF horizontally.Flexibility test using cadavers (6.9 Nm maximum moment).Biomechanical study showed that partial discectomy increases FLX, LB and AR motions significatly (Goel et al.).Evidence of hypermobility in patients (particularly female patients) after excision of L4-5 disc.No FLX/EXT changes in patients with discectomy and minimal laminectomy.When to fuse and when not to fuse? These initiated the controlled biomechanical studies on the effect of decompression on the spinal motion.Įffect of Discectomy in the Lumbar Spine.How much decompression can induce hypermobility?.Controversies associated with decompression:.Removal of spinal elements that impinge the spinal cord or nerve root due to spinal disorders, such as tumor, trauma, infection, or degenerative changes.Effect of Spinal Decompression on Spinal Stability ![]()
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