Flexibility and fatigue evaluation of oblique as compared with anterior lumbar interbody cages with integrated endplate fixation

This study was undertaken to quantify the in vitro range of motion (ROM) of oblique as compared with anterior lumbar interbody devices, pullout resistance, and subsidence in fatigue. Anterior and oblique cages with integrated plate fixation (IPF) were tested using lumbar motion segments. Flexibility...

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Bibliographic Details
Published inJournal of neurosurgery. Spine Vol. 24; no. 1; p. 54
Main Authors Freeman, Andrew L, Camisa, William J, Buttermann, Glenn R, Malcolm, James R
Format Journal Article
LanguageEnglish
Published United States 01.01.2016
Subjects
Adult
Aged
Biomechanical Phenomena - physiology
Bone Plates
Cadaver
Fatigue
Female
Humans
Lumbar Vertebrae - surgery
Lumbosacral Region - surgery
Male
Middle Aged
Pliability - physiology
Range of Motion, Articular - physiology
Spinal Fusion - instrumentation
interbody device
fatigue
pullout testing
ROM = range of motion
IPF = integrated plate fixation
DEXA = dual-energy x-ray absorptiometry
subsidence
interbody cage
lumbar spine biomechanics
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Summary:This study was undertaken to quantify the in vitro range of motion (ROM) of oblique as compared with anterior lumbar interbody devices, pullout resistance, and subsidence in fatigue. Anterior and oblique cages with integrated plate fixation (IPF) were tested using lumbar motion segments. Flexibility tests were conducted on the intact segments, cage, cage + IPF, and cage + IPF + pedicle screws (6 anterior, 7 oblique). Pullout tests were then performed on the cage + IPF. Fatigue testing was conducted on the cage + IPF specimens for 30,000 cycles. No ROM differences were observed in any test group between anterior and oblique cage constructs. The greatest reduction in ROM was with supplemental pedicle screw fixation. Peak pullout forces were 637 ± 192 N and 651 ± 127 N for the anterior and oblique implants, respectively. The median cage subsidence was 0.8 mm and 1.4 mm for the anterior and oblique cages, respectively. Anterior and oblique cages similarly reduced ROM in flexibility testing, and the integrated fixation prevented device displacement. Subsidence was minimal during fatigue testing, most of which occurred in the first 2500 cycles.
ISSN:1547-5646
DOI:10.3171/2015.4.SPINE14948