Biomechanical effect of interspinous dynamic stabilization adjacent to single-level fusion on range of motion of the transition segment and the adjacent segment

- We aimed to assess the biomechanical effect of fusion combined with Coflex on range of motion of the transition segment and the adjacent segment.
- Fusion combined with Coflex can stabilize the transition segment and restrict flexion and extension in that segment.
- Fusion combined with Coflex has no significant effect on the range of motion of the adjacent segment.
- Fusion combined with Coflex has no significant effect on the range of motion of the transition segment under lateral bending and axial rotation.

BackgroundDespite numerous biomechanical studies have been carried out on dynamic stabilizers, there is very little information on their hybrid application, especially when combined interspinous dynamic stabilization with single-level fusion. The aim of this study is to assess the biomechanical effect of interspinous dynamic stabilization adjacent to single-level fusion on range of motion of the transition segment and the adjacent segment.MethodsSix fresh lumbosacral spines (L2-S1) were tested in the following sequence: 1) intact (Construct A); 2) fusion in L5/S1 and intact in L4/5 (Construct B); 3) fusion in L5/S1 and unstable state in L4/5 (Construct C); 4) fusion in L5/S1 and Coflex in L4/5 (Construct D). Range of motion (at L3/4 and L4/5) was recorded and calculated.FindingsRange of motion in L3/4 in the four constructs showed no difference under all motion states. Under flexion/extension, the range of motion of L4/5 in Construct B and Construct C increased, while the range of motion of L4/5 in Construct D decreased compared with Construct A. Compared with Construct D, the range of motion of L4/5 in Constructs B and C showed a significant increase. Under lateral bending and axial rotation, Construct A showed similar range of motion of L3/4 compared with other constructs.InterpretationFusion combined with Coflex is able to stabilize the transition segment and restrict flexion and extension in that segment, while having no significant effect on the range of motion of the adjacent segment or the range of motion of the transition segment under lateral bending and axial rotation.