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Biomechanics of intervertebral cervical fusion cages

Lu Cao, Qian Chen, Li-Bo Jiang, Xiao-Fan Yin, Chong Bian, Hui-Ren Wang, Yi-Qun Ma, Xiang-Qian Li, Xi-Lei Li, Jian Dong
STUDY DESIGN: This is an experimental animal study. OBJECTIVE: The objective of this study was to compare an anterior cervical discectomy and interbody fusion of a novel polylactide/nano-sized β-tricalcium phosphate (PLA/nβ-TCP) bioabsorbable self-retaining cervical fusion cage (BCFC) with an autologous bone graft and polyetheretherketone (PEEK) cages. BACKGROUND: Although PLA cervical cages have potential advantages compared with traditional materials, they are not currently routinely used in spine surgery because of undesirable effects such as the lack of osteoconductivity and osteolysis around the implant...
2017: International Journal of Nanomedicine
Chunpeng Ren, Yueming Song, Youdi Xue, Xi Yang, Chunguang Zhou
BACKGROUND: Currently, polylactide is the most popular material used to made bioabsorbable cages but too-quick degradation and osteolysis around the cage have been reported in the literature. This study evaluated the fusion effect, biomechanical stability, and histologic characteristics of a novel bioabsorbable multiamino acid copolymer/nanohydroxyapatite/calcium sulfate (MAACP/n-HA/CS) interbody cage in a goat model of anterior cervical discectomy and fusion. METHODS: A total of 24 goats underwent C3/C4 discectomy and fusion with 3 groups of intervertebral implants: MAACP/n-HA/CS cage group (n = 8), titanium cage group (n = 8), and autologous tricortical iliac crest bone group (n = 8)...
July 2017: World Neurosurgery
Tzu-Tsao Chung, Dueng-Yuan Hueng, Shang-Chih Lin
This numerical study aimed to evaluate tissue and implant responses to the hybrid surgery (HS) of cervical artificial disc replacement (C-ADR) and anterior cervical discectomy and fusion (ACDF).Four hybrid strategies of two-level C-ADR and ACDF were compared in terms of adjacent segment degeneration (ASD) and implant failure.The rotary C-ADR and semirigid ACDF have been extensively used in the multilevel treatment of cervical instability and degeneration, but the constrained mobility at the ACDF segments can induce postoperative ASD problems...
November 2015: Medicine (Baltimore)
Xiao-Hui Li, Yue-Ming Song, Hong Duan
OBJECTIVES: To compare the characteristics of inter body fusion after using an established poly (D, L-lactic acid) (PDLLA) cage, a titanium cage or autologous tricortical iliac crest graft in a goat cervical spine model in vivo. METHODS: Twenty-four goats were assigned to three groups: PDLLA cage group (n = 8), titanium alloy cage group (n = 8) and autologous iliac bone group (n = 8), and underwent C3-4 discectomy and fusion with the allocated procedure. Radiography was performed pre- and post-operatively and after 1, 2, 4, 8 and 12 weeks and disc space height (DSH), intervertebral angle (IVA), and lordosis angle (LA) measured at these time points...
August 2015: Orthopaedic Surgery
Dorothea Daentzer, Elmar Willbold, Katharina Kalla, Ivonne Bartsch, Waseem Masalha, Maximiliane Hallbaum, Christof Hurschler, Theresa Kauth, Daniel Kaltbeitzel, Christian Hopmann, Bastian Welke
STUDY DESIGN: An experimental study using a sheep cervical spine interbody fusion model. OBJECTIVE: First, to compare anterior cervical discectomy and fusion of an experimental bioabsorbable cage consisting of a magnesium alloy and a polymer (poly-ε-caprolactone, PCL) with an autologous tricortical iliac crest bone graft. Second, to determine the degradation kinetics of the cage, assess the 2 fusion devices for biomechanical stability, and determine their histological characteristics...
September 15, 2014: Spine
Aniruddh N Nayak, Matthew I Stein, Chris R James, Roger B Gaskins, Andres F Cabezas, Maxwell Adu-Lartey, Antonio E Castellvi, Brandon G Santoni
BACKGROUND CONTEXT: Despite an increase in the clinical use of no-profile anchored interbody cages (AIC) for anterior cervical discectomy and fusion (ACDF) procedures, there is little published biomechanical data describing its stabilizing effect relative to the traditional anterior plating technique over two contiguous levels. PURPOSE: To biomechanically compare the acute stability conferred by a stand-alone interbody fusion device with three integrated fixation screws ("anchored cage") with a traditional six-hole rigid anterior plate in a two contiguous levels (C4-C5+C5-C6) fusion construct...
December 1, 2014: Spine Journal: Official Journal of the North American Spine Society
Kamran Aghayev, James J Doulgeris, Sabrina A Gonzalez-Blohm, Mohammed Eleraky, William E Lee, Frank D Vrionis
BACKGROUND: Common fusion techniques for cervical degenerative diseases include two-level anterior discectomy and fusion and one-level corpectomy and fusion. The aim of the study was to compare via in-vitro biomechanical testing the effects of a two-level anterior discectomy and fusion and a one-level corpectomy and fusion, with anterior plate reconstruction. METHODS: Seven fresh frozen human cadaveric spines (C3-T1) were dissected from posterior musculature, preserving the integrity of ligaments and intervertebral discs...
January 2014: Clinical Biomechanics
Bernhard Schöllhorn, Alexander Bürki, Christina Stahl, Judith Howard, Franck Forterre
OBJECTIVE: To evaluate fixation properties of a new intervertebral anchored fusion device and compare these with ventral locking plate fixation. STUDY DESIGN: In vitro biomechanical evaluation. ANIMALS: Cadaveric canine C4-C7 cervical spines (n = 9). METHODS: Cervical spines were nondestructively loaded with pure moments in a nonconstraining testing apparatus to induce flexion/extension while angular motion was measured...
October 2013: Veterinary Surgery: VS
Nathaniel R Ordway, Byeong Cheol Rim, Rong Tan, Rebecca Hickman, Amir H Fayyazi
Graft subsidence following anterior cervical reconstruction can result in the loss of sagittal balance and recurring foraminal stenosis. This study examined the implant-endplate interface using a cyclic fatigue loading protocol in an attempt to model the subsidence seen in vivo. The superior endplate from 30 cervical vertebrae (C3 to T1) were harvested and biomechanically tested in axial compression with one of three implants: Fibular allograft; titanium mesh cage packed with cancellous chips; and trabecular metal...
April 2012: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
P C Fernandes, P R Fernandes, J O Folgado, J Levy Melancia
This paper presents a biomechanical analysis of the cervical C5-C6 functional spine unit before and after the anterior cervical discectomy and fusion. The aim of this work is to study the influence of the medical procedure and its instrumentation on range of motion and stress distribution. First, a three-dimensional finite element model of the lower cervical spine is obtained from computed tomography images using a pipeline of image processing, geometric modelling and mesh generation software. Then, a finite element study of parameters' influence on motion and a stress analysis at physiological and different post-operative scenarios were made for the basic movements of the cervical spine...
2012: Computer Methods in Biomechanics and Biomedical Engineering
Amy S Lyons, Blake P Sherman, Christian M Puttlitz, Vikas V Patel, Celeste Abjornson, Anthony Simon Turner, Howard B Seim, Evalina L Burger, Emily M Lindley
BACKGROUND CONTEXT: Containment plates are often placed anteriorly in anterior cervical discectomy and fusion (ACDF) to provide stability and prevent migration of the interbody device or autograft. The main advantage of a bioresorbable plate over the typical metallic plate is that it will resorb after fusion has occurred, thus mitigating any long-term instrumentation-related complications. Furthermore, the plates are radiolucent, allowing complete visualization of the fusion site and eliminating imaging artifact...
September 2011: Spine Journal: Official Journal of the North American Spine Society
Zhou Chunguang, Song Yueming, Tu Chongqi, Duan Hong, Pei Fuxing, Yan Yonggang, Li Hong
STUDY DESIGN: A study of cervical interbody fusion using polyamino acid-based bioabsorbable fusion cages in a goat model. OBJECTIVE: To compare interbody fusion of a bioabsorbable multiamino acid copolymer/α-tri-calcium phosphate (MAACP/α-TCP) fusion cage with an autologous tricortical iliac-crest bone graft and a titanium cage. SUMMARY OF BACKGROUND DATA: Polyamino acid is widely used as a carrier for drug delivery. To our knowledge, no study investigates interbody fusion cage made of polyamino acid...
December 1, 2011: Spine
L C Espinha, P R Fernandes, J Folgado
The anterior cervical fusion is an established surgical procedure for spine stabilization after the removal of an intervertebral disc. However, it is not yet clear which bone graft represents the best choice and whether surgical devices can be efficient and beneficial for fusion. The aim of this work is to study the influence of the spine instrumentation on bone remodeling after a cervical spine surgery and, consequently, on the fusion process. A finite element model of the cervical spine was developed, having computed tomography images as input...
November 16, 2010: Journal of Biomechanics
Bryan W Cunningham, John C Sefter, Nianbin Hu, Paul C McAfee
OBJECT: Using an in vivo caprine model, authors in this study compared the efficacy of autologous growth factors (AGFs) with autogenous graft for anterior cervical interbody arthrodesis. METHODS: Fourteen skeletally mature Nubian goats were used in this study and followed up for a period of 16 weeks postoperatively. Anterior cervical interbody arthrodesis was performed at the C3-4 and C5-6 vertebral levels. Four interbody treatment groups (7 animals in each group) were equally randomized among the 28 arthrodesis sites: Group 1, autograft alone; Group 2, autograft + cervical cage; Group 3, AGFs + cervical cage; and Group 4, autograft + anterior cervical plate...
August 2010: Journal of Neurosurgery. Spine
Frode Kolstad, Øystein P Nygaard, Hege Andresen, Gunnar Leivseth
STUDY DESIGN: Prospective, observational study. OBJECTIVE: To evaluate biomechanical changes associated with cervical arthrodesis using a cylindrical titanium cage. SUMMARY OF BACKGROUND DATA: Anterior cervical discectomy and fusion (ACDF) is the "gold standard" for treating cervical disc disease. In an effort to avoid the morbidity associated with autogenous bone graft harvesting, cervical cages are used to achieve fusion. The cages should allow for restoration and maintenance of natural disc height, angulations, and displacements at the operated levels...
July 15, 2010: Spine
Songkai Li, Bin Ni, Ning Xie, Mingfei Wang, Xiang Guo, Feng Zhang, Jian Wang, Weidong Zhao
STUDY DESIGN: A biomechanical testing protocol was used to evaluate atlantoaxial fixation techniques in a human cadaveric model. OBJECTIVE: To compare in vitro biomechanics of atlantoaxial lateral mass fusion cage combined with C1-C2 pedicle screw technique with those of C1-C2 pedicle screw technique alone and C1-C2 transarticular screws combined with Gallie wires. SUMMARY OF BACKGROUND DATA: An atlantoaxial lateral mass fusion cage was designed, knowing that the cage, when rigidly combined with C1-C2 pedicle screws, could offer other fusion spots for atlantoaxial stabilization in cases when the posterior arch of the atlas is absent or removed for decompression and a Gallie fixation is impossible...
June 15, 2010: Spine
Szilárd Pazdernyik, László Sándor, Péter Elek, Pál Barzó
Both acute and chronic instability of the cervical spine can be succesfully treated by anterior crevical fusion. The main goal is to create a spondylodesis through which the instable motion segments are fixed in the position defined by the surgeon. The spondylodesis is realised by the bone healing of the intervertebral space. The consolidation itself is facilitated by the operative stabilisation of the segments involved, and also by the implantation/transplantation of the osteoproductive/osteoinductive materials...
January 30, 2010: Ideggyógyászati Szemle
Bo Young Cho, Jesse Lim, Hong Bo Sim, Jon Park
STUDY DESIGN: The study design was that of an in vitro human cadaveric biomechanical analysis. OBJECTIVES: The objective of this study was the biomechanical analysis of the range of motion (ROM) of a 2-level intact spine control versus total, then operative- and adjacent-segment ROM after (1) 2-level ProDisc-C placement (PP), (2) anterior cervical discectomy and fusions (ACDFs), and (3) hybrid constructs of both. Follower load and multidirectional testing were performed in each instance...
September 1, 2010: Spine
Yu-tong Gu, Zhen-jun Yao, Lian-shun Jia, Jin Qi, Jun Wang
The purpose of this study was to compare the characteristics of interbody fusion achieved using the hat type cervical intervertebral fusion cage (HCIFC) with those of an autologous tricortical iliac crest graft, Harms cage and the carbon cage in a goat cervical spine model. Thirty-two goats underwent C3-4 discectomy and fusion. They were subdivided into four groups of eight goats each: group 1, autologous tricortical iliac crest bone graft; group 2, Harms cage filled with autologous iliac crest graft; group 3, carbon cage filled with autologous iliac bone; and group 4, HCIFC filled with autologous iliac graft...
December 2010: International Orthopaedics
Bryan W Cunningham, Nianbin Hu, Candace M Zorn, Paul C McAfee
OBJECT: Using a synthetic vertebral model, the authors quantified the comparative fixation strengths and failure mechanisms of 6 cervical disc arthroplasty devices versus 2 conventional methods of cervical arthrodesis, highlighting biomechanical advantages of prosthetic endplate fixation properties. METHODS: Eight cervical implant configurations were evaluated in the current investigation: 1) PCM Low Profile; 2) PCM V-Teeth; 3) PCM Modular Flange; 4) PCM Fixed Flange; 5) Prestige LP; 6) Kineflex/C disc; 7) anterior cervical plate + interbody cage; and 8) tricortical iliac crest...
February 2010: Journal of Neurosurgery. Spine
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