Biomechanical analysis of multilevel discectomy and excision of posterior longitudinal ligament: An in vitro study in sheep

Aim: This experimental biomechanical study was performed to determine the effects of multilevel anterior cervical discectomy and excision of posterior longitudinal ligament (PLL) to stabilize the cervical spine using an in vitro animal model. Materials and Methods: Fifty fresh cadaveric C3-C6 sheep spine specimens were divided into five experimental groups: Group A was the control group; Group B, one-level discectomy; Group C, two- level discectomy, Group D, three-level discectomy, and Group E, three-level discectomy and excision of PLL, respectively. The specimens were subjected to non-destructive loads cycled from zero to five Newton-meter for flexion, extension, right and left lateral bending, and axial rotation on an electrohydraulic test machine. Load displacement curves were obtained via collected data using strain gauges. The values were obtained for all five groups, statistical differences were determined respectively (P < 0.05, ANOVA). Results: One- level discectomy was less stable than the control group, two-level discectomy was less stable than one-level discectomy and three-level discectomy was less stable than two-level discectomy, respectively (P < 0.05). Excision of PLL did not seem to affect stability (P > 0.05). Conclusion: Our data suggested that cervical discectomy decreases stability of sheep spine pieces.