A Novel Spinal Implant for Fusionless Scoliosis Correction: A Biomechanical Analysis of the Motion Preserving Properties of a Posterior Periapical Concave Distraction Device

Roderick M. Holewijn, Marinus de Kleuver, Albert J. van der Veen, Kaj S. Emanuel, Arno Bisschop, Agnita Stadhouder, Barend J. van Royen, Idsart Kingma

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Study Design: Biomechanical study. Objective: Recently, a posterior concave periapical distraction device for fusionless scoliosis correction was introduced. The goal of this study was to quantify the effect of the periapical distraction device on spinal range of motion (ROM) in comparison with traditional rigid pedicle screw-rod instrumentation. Methods: Using a spinal motion simulator, 6 human spines were loaded with 4 N m and 6 porcine spines with 2 N m to induce flexion-extension (FE), lateral bending (LB), and axial rotation (AR). ROM was measured in 3 conditions: untreated, periapical distraction device, and rigid pedicle screw-rod instrumentation. Results: The periapical distraction device caused a significant (P <.05) decrease in ROM of FE (human, −40.0% and porcine, −55.9%) and LB (human, −18.2% and porcine, −17.9%) as compared to the untreated spine, while ROM of AR remained unaffected. In comparison, rigid instrumentation caused a significantly (P <.05) larger decrease in ROM of FE (human, −80.9% and porcine, −94.0%), LB (human, −75.0% and porcine, −92.2%), and AR (human, −71.3% and porcine, −86.9%). Conclusions: Although no destructive forces were applied, no device failures were observed. Spinal ROM was significantly less constrained by the periapical distraction device compared to rigid pedicle screw-rod instrumentation. Therefore, provided that scoliosis correction is achieved, a more physiological spinal motion is expected after scoliosis correction with the posterior concave periapical distraction device.

Original languageEnglish
Pages (from-to)400-409
Number of pages10
JournalGlobal Spine Journal
Volume7
Issue number5
DOIs
Publication statusPublished - 1 Aug 2017

Cite this

@article{3f30399262d94948b3679e613f02ac57,
title = "A Novel Spinal Implant for Fusionless Scoliosis Correction: A Biomechanical Analysis of the Motion Preserving Properties of a Posterior Periapical Concave Distraction Device",
abstract = "Study Design: Biomechanical study. Objective: Recently, a posterior concave periapical distraction device for fusionless scoliosis correction was introduced. The goal of this study was to quantify the effect of the periapical distraction device on spinal range of motion (ROM) in comparison with traditional rigid pedicle screw-rod instrumentation. Methods: Using a spinal motion simulator, 6 human spines were loaded with 4 N m and 6 porcine spines with 2 N m to induce flexion-extension (FE), lateral bending (LB), and axial rotation (AR). ROM was measured in 3 conditions: untreated, periapical distraction device, and rigid pedicle screw-rod instrumentation. Results: The periapical distraction device caused a significant (P <.05) decrease in ROM of FE (human, −40.0{\%} and porcine, −55.9{\%}) and LB (human, −18.2{\%} and porcine, −17.9{\%}) as compared to the untreated spine, while ROM of AR remained unaffected. In comparison, rigid instrumentation caused a significantly (P <.05) larger decrease in ROM of FE (human, −80.9{\%} and porcine, −94.0{\%}), LB (human, −75.0{\%} and porcine, −92.2{\%}), and AR (human, −71.3{\%} and porcine, −86.9{\%}). Conclusions: Although no destructive forces were applied, no device failures were observed. Spinal ROM was significantly less constrained by the periapical distraction device compared to rigid pedicle screw-rod instrumentation. Therefore, provided that scoliosis correction is achieved, a more physiological spinal motion is expected after scoliosis correction with the posterior concave periapical distraction device.",
keywords = "adolescent idiopathic scoliosis, ApiFix, in vitro biomechanics, less invasive scoliosis surgery, nonfusion",
author = "Holewijn, {Roderick M.} and {de Kleuver}, Marinus and {van der Veen}, {Albert J.} and Emanuel, {Kaj S.} and Arno Bisschop and Agnita Stadhouder and {van Royen}, {Barend J.} and Idsart Kingma",
year = "2017",
month = "8",
day = "1",
doi = "10.1177/2192568217699377",
language = "English",
volume = "7",
pages = "400--409",
journal = "Global Spine Journal",
issn = "2192-5682",
publisher = "Thieme Medical Publishers",
number = "5",

}

A Novel Spinal Implant for Fusionless Scoliosis Correction : A Biomechanical Analysis of the Motion Preserving Properties of a Posterior Periapical Concave Distraction Device. / Holewijn, Roderick M.; de Kleuver, Marinus; van der Veen, Albert J.; Emanuel, Kaj S.; Bisschop, Arno; Stadhouder, Agnita; van Royen, Barend J.; Kingma, Idsart.

In: Global Spine Journal, Vol. 7, No. 5, 01.08.2017, p. 400-409.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - A Novel Spinal Implant for Fusionless Scoliosis Correction

T2 - A Biomechanical Analysis of the Motion Preserving Properties of a Posterior Periapical Concave Distraction Device

AU - Holewijn, Roderick M.

AU - de Kleuver, Marinus

AU - van der Veen, Albert J.

AU - Emanuel, Kaj S.

AU - Bisschop, Arno

AU - Stadhouder, Agnita

AU - van Royen, Barend J.

AU - Kingma, Idsart

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Study Design: Biomechanical study. Objective: Recently, a posterior concave periapical distraction device for fusionless scoliosis correction was introduced. The goal of this study was to quantify the effect of the periapical distraction device on spinal range of motion (ROM) in comparison with traditional rigid pedicle screw-rod instrumentation. Methods: Using a spinal motion simulator, 6 human spines were loaded with 4 N m and 6 porcine spines with 2 N m to induce flexion-extension (FE), lateral bending (LB), and axial rotation (AR). ROM was measured in 3 conditions: untreated, periapical distraction device, and rigid pedicle screw-rod instrumentation. Results: The periapical distraction device caused a significant (P <.05) decrease in ROM of FE (human, −40.0% and porcine, −55.9%) and LB (human, −18.2% and porcine, −17.9%) as compared to the untreated spine, while ROM of AR remained unaffected. In comparison, rigid instrumentation caused a significantly (P <.05) larger decrease in ROM of FE (human, −80.9% and porcine, −94.0%), LB (human, −75.0% and porcine, −92.2%), and AR (human, −71.3% and porcine, −86.9%). Conclusions: Although no destructive forces were applied, no device failures were observed. Spinal ROM was significantly less constrained by the periapical distraction device compared to rigid pedicle screw-rod instrumentation. Therefore, provided that scoliosis correction is achieved, a more physiological spinal motion is expected after scoliosis correction with the posterior concave periapical distraction device.

AB - Study Design: Biomechanical study. Objective: Recently, a posterior concave periapical distraction device for fusionless scoliosis correction was introduced. The goal of this study was to quantify the effect of the periapical distraction device on spinal range of motion (ROM) in comparison with traditional rigid pedicle screw-rod instrumentation. Methods: Using a spinal motion simulator, 6 human spines were loaded with 4 N m and 6 porcine spines with 2 N m to induce flexion-extension (FE), lateral bending (LB), and axial rotation (AR). ROM was measured in 3 conditions: untreated, periapical distraction device, and rigid pedicle screw-rod instrumentation. Results: The periapical distraction device caused a significant (P <.05) decrease in ROM of FE (human, −40.0% and porcine, −55.9%) and LB (human, −18.2% and porcine, −17.9%) as compared to the untreated spine, while ROM of AR remained unaffected. In comparison, rigid instrumentation caused a significantly (P <.05) larger decrease in ROM of FE (human, −80.9% and porcine, −94.0%), LB (human, −75.0% and porcine, −92.2%), and AR (human, −71.3% and porcine, −86.9%). Conclusions: Although no destructive forces were applied, no device failures were observed. Spinal ROM was significantly less constrained by the periapical distraction device compared to rigid pedicle screw-rod instrumentation. Therefore, provided that scoliosis correction is achieved, a more physiological spinal motion is expected after scoliosis correction with the posterior concave periapical distraction device.

KW - adolescent idiopathic scoliosis

KW - ApiFix

KW - in vitro biomechanics

KW - less invasive scoliosis surgery

KW - nonfusion

UR - http://www.scopus.com/inward/record.url?scp=85026779087&partnerID=8YFLogxK

U2 - 10.1177/2192568217699377

DO - 10.1177/2192568217699377

M3 - Article

VL - 7

SP - 400

EP - 409

JO - Global Spine Journal

JF - Global Spine Journal

SN - 2192-5682

IS - 5

ER -