Biomechanics of Grade I degenerative lumbar spondylolisthesis. Part 1: In vitro model

Abstract

Object. The authors sought to create and to evaluate an in vitro model of Grade I degenerative (closed-arch) spondylolisthesis. Methods. The model of spondylolisthesis was created by two primary procedures: 1) resection of the disc; and 2) stripping of anterior and posterior longitudinal ligaments away from the vertebral bodies (VBs). In 13 vertebral levels obtained from three cadaveric lumbar spines, the tissues were resected sequentially in alternating order to determine the relative contribution of each resection to spinal instability. The entire specimens were loaded with nonconstraining torques and then individual levels were loaded with anteroposterior shear forces. The motion values were measured optoelectronically for each specimen at individual levels. Conclusions. The integrity of the disc was more important than attachment of the ligaments to the VB, but the resection of both structures was necessary to achieve substantial destabilization. The structures of the spine are highly resilient, and destabilization is difficult to achieve without performing extensive resection. Using the techniques described in this paper to alter normal spines, a level of spinal instability (Grade I; 25% slippage) that may represent spondylolisthesis can be modeled in vitro.