Article Figures & Data
Figures
- Figure 1
Diagram of L4 vertebra with inferior half of L3 to L4 disc. The dashed red line indicates the trajectory of the cut to completely release the anterior longitudinal ligament (ALL). The rightmost red hash perpendicular to the trajectory indicates the first cut, resecting 1/3 of the width of the ALL (1/3 ALL release). The middle red hash indicates the second cut, resecting another 1/3 of the width of the ALL (2/3 ALL release). The left hash indicates the starting point for the cut to achieve complete ALL release (3/3 ALL release).
- Figure 2
Representative anterior-to-psoas lumbar interbody fusion (ATP-LIF) constructs with sequential anterior longitudinal ligament (ALL) release.
- Figure 3
L2 to L5 specimen on the 6-degrees-of-freedom motion simulator. Applied bending movements are indicated as flexion-extension (FE), lateral bending (LB), and axial rotation (AR).
- Figure 4
Range of motion (ROM) at L3 to L4 in flexion-extension (FE), lateral bending (LB), and axial rotation (AR) following sequential anterior longitudinal ligament (ALL) release. * P < 0.05 vs intact.
- Figure 5
Radiographic trends of (A) intervertebral angle (IVA) and (B) intradiscal heights (posterior disc height [PDH], anterior disc height [ADH], and foraminal height [FH]) following sequential anterior longitudinal ligament (ALL) release. *P < 0.05 vs intact. †P < 0.05 vs anterior-to-psoas lumbar interbody fusion (ATP-LIF). ‡P < 0.05 vs 1/3 ALL release. §P < 0.05 vs 2/3 ALL release.
- Figure 6
Average range of motion (ROM; flexion-extension [FE], lateral bending [LB], and axial rotation [AR]) and intervertebral angle (IVA) following sequential anterior longitudinal ligament (ALL) release.
Tables
Specimen Age, y Sex BMD,
T-scoreSpacer Angle (°) 1 30 F –1.3 10 2 61 F –1.9 10 3 20 F –.2 6 4 62 F –1.3 6 5 75 M –2.3 10 6 72 M –.9 6 7 62 M –1.8 6 Summary 54.6 ± 21.1 3 M and 4 F –1.4 ± 0.7 4 at 6° and 3 at 10° Abbreviations: BMD, bone mineral density; F, female; M, male.
Construct ROM (°), mean ± SD FE LB AR Intact 6.21 ± 2.37 9.52 ± 3.87 3.49 ± 1.11 ATP-LIF 1.11 ± 0.41 1.31 ± 0.83 1.03 ± 0.27 1/3 ALL release 1.25 ± 0.50 0.95 ± 0.46 0.91 ± 0.25 2/3 ALL release 2.04 ± 1.61 1.01 ± 0.54 0.90 ± 0.33 3/3 ALL release 2.12 ± 1.52 1.21 ± 0.67 0.90 ± 0.31 Abbreviations: ALL, anterior longitudinal ligament; AR, axial rotation; ATP-LIF, anterior-to-psoas lumbar interbody fusion; FE, flexion-extension; LB, lateral bending; ROM, range of motion.
Construct Radiographic Parameters, mean ± SD IVA (°) ADH (mm) PDH (mm) FH (mm) FA (mm2) Intact 5.3 ± 2.8 13.6 ± 3.0 7.0 ± 0.9 19.6 ± 3.2 118.1 ± 42.0 ATP-LIF 6.1 ± 2.3 16.2 ± 1.8 9.3 ± 1.6 21.7 ± 2.4 135.4 ± 37.5 1/3 ALL release 7.6 ± 2.3 17.6 ± 1.8 9.9 ± 1.4 22.4 ± 1.7 139.9 ± 38.7 2/3 ALL release 10.3 ± 3.4 19.5 ± 2.4 10.3 ± 1.7 22.7 ± 1.8 139.7 ± 38.3 3/3 ALL release 14.1 ± 3.7 22.5 ± 3.2 10.7 ± 1.6 23.0 ± 1.8 141.5 ± 39.6 Abbreviations: ADH, anterior disc height; ALL, anterior longitudinal ligament; ATP-LIF, anterior-to-psoas lumbar interbody fusion; FA, foraminal area; FH, foraminal height; IVA, intervertebral angle; PDH, posterior disc height.
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