Brandolini, N, Kapur, N and Hall, RM (2014) Dynamics of interpedicular widening in spinal burst fractures: an in vitro investigation. Spine Journal, 14 (9). pp. 2164-2171. ISSN 1529-9430
Abstract
BACKGROUND CONTEXT: Spinal burst fractures are a significant cause of spinal instability and neurologic impairment. Although evidence suggests that the neurologic trauma arises during the dynamic phase of fracture, the biomechanics underpinning the phenomenon has yet to be fully explained. Interpedicular widening (IPW) is a distinctive feature of the fracture but, despite the association with the occurrence of neurologic deficit, little is known about its biomechanics. PURPOSE: To provide a comprehensive in vitro study on spinal burst fracture, with special attention on the dynamics of IPW. STUDY DESIGN: Experimental measurements in combination with computed tomography scanning were used to quantitatively investigate the biomechanics of burst fracture in a cadaveric model. METHODS: Twelve human three-adjacent-vertebra segments were tested to induce burst fracture. Impact was delivered through a drop-weight tower, whereas IPW was continuously recorded by two displacement transducers. Computed tomography scanning aided quantifying canal occlusion (CO) and evaluating sample anatomy and fracture appearance. Two levels of energy were delivered to two groups: high energy (HE) and low energy (LE). RESULTS: No difference was found between HE and LE in terms of the residual IPW (ie, post-fracture), maximum IPW, or CO (median 20.2%). Whereas IPW was not found to be correlated with CO, a moderate correlation was found between the maximum and the residual IPW. At the fracture onset, IPW reached a maximum median value of 15.8% in approximately 20 to 25 milliseconds. After the transient phase, the pedicles were recoiled to a median residual IPW of 4.9%. CONCLUSIONS: Our study provides for the first time insight on how IPW actually evolves during the fracture onset. In addition, our results may help shedding more light on the mechanical initiation of the fracture.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2014 Elsevier Inc. This is an author produced version of a paper published in The Spine Journal. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Canal occlusion; Dynamic interpedicular widening; Dynamics of spinal burst fracture; Fracture of the pedicle; High resolution peripheral quantitative computed tomography; In vitro biomechanics of the spine; Laminar fracture |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Mechanical Engineering (Leeds) > Institute of Engineering Thermofluids, Surfaces & Interfaces (iETSI) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 23 Mar 2016 14:50 |
Last Modified: | 15 Nov 2016 19:17 |
Published Version: | http://dx.doi.org/10.1016/j.spinee.2014.01.058 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.spinee.2014.01.058 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:95095 |