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Finite element analysis and cadaveric cinematic analysis of fixation options for anteriorly implanted trabecular metal interbody cages

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Abstract

Purpose

To assess, with finite element analysis and an in vitro biomechanical study in cadaver, whether the implementation of an anterior interbody cage made of hedrocel with nitinol shape memory staples in compression increases the stiffness of the stand-alone interbody cage and to compare these constructs’ stiffness to other constructs common in clinical practice.

Methods

A biomechanical study with a finite element analysis and cadaveric testing assessed the stiffness of different fixation modes for the L4–L5 functional spinal unit: intact spine, destabilized spine with discectomy, posterior pedicle-screw fixation, anterior stand-alone interbody cage, anterior interbody cage with bilateral pedicle screws and anterior interbody cage with two shape memory staples in compression. These modalities of vertebral fixation were compared in four loading modes (flexion, extension, lateral bending, and axial rotation).

Results

The L4–L5 spinal unit with an anterior interbody cage and two staples was stiffer than the stand-alone cage. The construct stiffness was similar to that of a model of posterior pedicular stabilization. The stiffness was lower than that of the anterior cage plus bilateral pedicle-screw fixation.

Conclusion

The use of an anterior interbody implant with shape memory staples in compression may be an alternative to isolated posterior fixation and to anterior isolated implants, with increased stiffness.

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Author information

Authors and Affiliations

  1. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

    Pedro Berjano

  2. Spine Unit, University Hospital of Salamanca, Salamanca, Spain

    Juan Francisco Blanco & David Pescador

  3. Department of Orthopedic Surgery, University Hospital of Salamanca, Salamanca, Spain

    Diego Rendon

  4. IRCCS Don Gnocchi Foundation, Milan, Italy

    Jorge Hugo Villafañe

  5. Instituto de Biomecánica de Valencia, Universidad Politécnica de Valencia, Valencia, Spain

    Carlos Manuel Atienza

Authors
  1. Pedro Berjano
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  2. Juan Francisco Blanco
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  3. Diego Rendon
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  4. Jorge Hugo Villafañe
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  5. David Pescador
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  6. Carlos Manuel Atienza
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Corresponding author

Correspondence to Jorge Hugo Villafañe.

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Conflict of interest

The authors of the paper have not received specific funding to perform the research. No conflict of interest has to be declared by any of the authors.

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Berjano, P., Blanco, J.F., Rendon, D. et al. Finite element analysis and cadaveric cinematic analysis of fixation options for anteriorly implanted trabecular metal interbody cages. Eur Spine J 24 (Suppl 7), 918–923 (2015). https://doi.org/10.1007/s00586-015-4277-3

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  • DOI: https://doi.org/10.1007/s00586-015-4277-3

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