Meta-analyses comparing spine simulators with cadavers and finite element models by analysing range-of-motion data before and after lumbar total disc replacement

• Published in: Journal of advanced research Vol. 26; pp. 29 - 41
• Main Authors: Bohn, Tobias, Lang, Susanne A.J., Roll, Stephanie, Schrader, Helene, Pumberger, Matthias, Büttner-Janz, Karin
• Format: Journal Article
• Language: English
• Published: Egypt Elsevier B.V 01.11.2020; Elsevier
• Subjects: In vitro test methods; Meta-analysis; Range of motion; Total disc replacement; Range of motion; In vitro test methods; Total disc replacement; Meta-analysis
• DOI: 10.1016/j.jare.2020.06.017
• ISSN: 2090-1232

[Display omitted] •Data from two different in vitro test methods for the same evaluation subjects were compared. It was investigated whether spine simulators with real human cadavers (SSCs) and finite element models (FEMs) provide the same data exemplarily for range of motion (ROM) before and after insertion of motion-retaining devices.•Only fifty-nine percent of SSC meta-analyses show restored ROM after insertion of the device compared to the intact spinal segment. In FEM meta-analyses, ROM is restored in ninety percent.•Ten percent of ROM analyses show significantly different data between SSCs and FEMs.•With regard to the included studies, data generated by SSCs and FEMs cannot be used unrestricted as alternative and complementary data.•Our analysis provides a new approach to compare data from associated test methods. Range-of-motion (ROM) data generated by the in vitro test methods of spine simulators with cadavers (SSCs) and finite element models (FEMs) are used alternatively and complementarily for in vitro evaluations. Our purpose is to compare exemplary segmental ROM data from SSCs and FEMs before and after ball-and-socket total disc replacement (bsTDR) to determine whether the two test methods provide the same data for the same evaluation subjects. We performed 70 meta-analyses (MAs) and 20 additional comparative analyses based on data from 21 SSC studies used for 39 MAs and 16 FEM studies used for 31 MAs. Only fifty-nine percent (n = 23/39) of SSC MAs show a restored ROM after bsTDR, whereas in FEM MAs, the ROM is restored in ninety percent (n = 28/31). Among the analyses comparing data from the same spinal segments, motion directions and bsTDR, SSC and FEM data are significantly different in ten percent (n = 2/20). According to our results, data generated by SSCs and FEMs cannot be used as alternative and complementary data without restriction. The quality of the evaluation methods itself as well as potential technical reasons for the discrepant results were not our evaluation target. Further SSC and FEM data should be compared using the same approach.