Nonfusion Techniques for Degenerative Lumbar Diseases Treatment
Abstract
Another post-operative complication, related to fusion, is pseudoarthrosis, compromising the final result of the surgery (Kornblum et al, 2004).In order to achieve good results in fusion, consolidation of the bony fusion is critical (Butterman et al, 1998).However, a study of Muholand and Sengupta (2002) noted that bony consolidation, with achieved fusion segment, does not represent necessarily a clinical success.Rham and Hall (1996), in their study, also demonstrated that, in pseudoarthrosis, micromovements in the facet joint preserves hypermobility in the adjacent segments, acting www.intechopen.comLow Back Pain Pathogenesis and Treatment 164 like a "protective factor for the development of the adjacent segment degeneration".This finding was also described in 2004 by Ghiselli and collaborators.With all these evidences, nonfusion techniques arise, aiming the prevention of ADD, and the fact that this new technology does not require bone graft, since these techniques don´t depend on bony consolidation. The lumbar stabilityIn 1990, White and Panjabi defined instabillity of the spine as "the loss of the spine´s ability to maintain its patterns of displacement under physiologic loads so there is no initial or additional neurologic deficit, no major deformity, and no incapacitating pain".The importance of lumbar stability was originally established by Kruton (1944).Morgan and King (1957) reported that instability was a primary cause of low back pain.The degenerative process of…
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