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Biomechanical Analysis of Range of Motion and Failure Characteristics of Osteoporotic Spinal Compression Fractures in Human Cadaver

Indian Journal of Orthopaedics volume 51, pages 672–676 (2017)Cite this article

Abstract

Background

Vertebroplasty is a treatment for osteoporotic vertebral compression fractures. The optimal location of needle placement for cement injection remains a topic of debate. As such, the authors assessed the effects of location of two types of cement instillations. In addition, the motion and failure modes at the index and adjacent segments were measured.

Materials and Methods

Seven human osteoporotic cadaver spines (T1-L4), cut into four consecutive vertebral segments, were utilized. Of these, following the exclusion of four specimens not suitable to utilize for analysis, a total of 24 specimens were evaluable. Segments were randomly assigned into four treatment groups: unipedicular and bipedicular injections into the superior quartile or the anatomic center of the vertebra using confdence (Confdence Spinal Cement System®, DePuy Spine, Raynham, MA, USA) or polymethyl methacrylate. The specimens were subjected to nondestructive pure moments of 5 Nm, in 2.5 Nm increments, using pulleys and weights to simulate six degrees of physiological motion. A follower preload of 200 N was applied in fiexion extension. Testing sequence: range of motion (ROM) of intact specimen, fracture creation, cement injection, ROM after cement, and compression testing until failure. Nonconstrained motion was measured at the index and adjacent levels.

Results

At the index level, no significant differences were observed in ROM in all treatment groups (P > 0.05). There was a significant increase in adjacent level motion only for the treatment group that received a unipedicular cement injection at the anatomic center.

Conclusion

The location of the needle (superior or central) and treatment type (unipedicular or bipedicular) had no significant effect on the ROM at the index site. At the adjacent levels, a significant increase occurred with therapy through a unipedicular approach into the centrum of the vertebra at the treated segment.

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Affiliations

  1. Department of Neurological Surgery, Rutgers New Jersey Medical School, Spine Biomechanics Laboratory, New Jersey, 90 Bergen Street, Suite 8100, 07101-1709, Newark, United States of America

    Robert F Heary, Naresh K Parvathreddy & Nitin Agarwal

  2. Department of Neurological Surgery, Spine Biomechanics Laboratory, Rutgers New Jersey Medical School, Pennsylvania, Pittsburgh, United States of America

    Nitin Agarwal

Authors
  1. Robert F Heary
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  2. Naresh K Parvathreddy
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  3. Nitin Agarwal
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Correspondence to Robert F Heary.

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Heary, R.F., Parvathreddy, N.K. & Agarwal, N. Biomechanical Analysis of Range of Motion and Failure Characteristics of Osteoporotic Spinal Compression Fractures in Human Cadaver. IJOO 51, 672–676 (2017). https://doi.org/10.4103/ortho.IJOrtho_147_16

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  • DOI: https://doi.org/10.4103/ortho.IJOrtho_147_16

Keywords

  • Compression fractures
  • failure characteristics
  • osteoporotic human cadavers
  • range of motion
  • vertebroplasty

MeSH terms

  • Spinal cord injuries
  • cadaveric
  • bone cements
  • biomechanics