A Biomechanical Model for Testing Cage Subsidence in Spine Specimens with Osteopenia or Osteoporosis Under Permanent Maximum Load.

Autor: Schleifenbaum S; Zentrum zur Erforschung der Stuetz- und Bewegungsorgane, University of Leipzig, Leipzig, Germany; Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany., Heilmann R; Zentrum zur Erforschung der Stuetz- und Bewegungsorgane, University of Leipzig, Leipzig, Germany; Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany., Riemer E; Zentrum zur Erforschung der Stuetz- und Bewegungsorgane, University of Leipzig, Leipzig, Germany; Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany., Reise R; Zentrum zur Erforschung der Stuetz- und Bewegungsorgane, University of Leipzig, Leipzig, Germany; Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany., Heyde CE; Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany., Jarvers JS; Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany., Pieroh P; Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany., Völker A; Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany., von der Hoeh NH; Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany. Electronic address: Nicolas.vonderHoeh@medizin.uni-leipzig.de.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2021 Aug; Vol. 152, pp. e540-e548. Date of Electronic Publication: 2021 Jun 12.
DOI: 10.1016/j.wneu.2021.05.131
Abstrakt: Background: Intervertebral fusions in cases of reduced bone density are a tough challenge. From a biomechanical point of view, most current studies have focused on the range of motion or have shown test setups for single-component tests. Definitive setups for biomechanical testing of the primary stability of a 360° fusion using a screw-rod system and cage on osteoporotic spine are missing. The aim of this study was to develop a test stand to provide information about the bone-implant interface under reproducible conditions.
Methods: After pretesting with artificial bone, functional spine units were tested with 360° fusion in the transforaminal lumbar interbody fusion technique. The movement sequences were conducted in flexion/extension, right and left lateral bending, and right and left axial rotation on a human model with osteopenia or osteoporosis under permanent maximum load with 7.5 N-m.
Results: During the testing of human cadavers, 4 vertebrae were fully tested and were inconspicuous even after radiological and macroscopic examination. One vertebra showed a subsidence of 2 mm, and 1 vertebra had a cage collapsed into the vertebra.
Conclusions: This setup is suitable for biomechanical testing of cyclical continuous loads on the spine with reduced bone quality or osteoporosis. The embedding method is stable and ensures a purely single-level setup with different trajectories, especially when using the cortical bone trajectory. Optical monitoring provides a very accurate indication of cage movement, which correlates with the macroscopic and radiological results.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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