Biomechanical Evaluation of a Novel Lumbosacral Axial Fixation Device

2005 ◽  
Vol 127 (6) ◽  
pp. 929-933 ◽  
Author(s):  
Eric H. Ledet ◽  
Michael P. Tymeson ◽  
Simon Salerno ◽  
Allen L. Carl ◽  
Andrew Cragg

Background: Interbody arthrodesis is employed in the lumbar spine to eliminate painful motion and achieve stability through bony fusion. Bone grafts, metal cages, composite spacers, and growth factors are available and can be placed through traditional open techniques or minimally invasively. Whether placed anteriorly, posteriorly, or laterally, insertion of these implants necessitates compromise of the anulus—an inherently destabilizing procedure. A new axial percutaneous approach to the lumbosacral spine has been described. Using this technique, vertical access to the lumbosacral spine is achieved percutaneously via the presacral space. An implant that can be placed across a motion segment without compromise to the anulus avoids surgical destabilization and may be advantageous for interbody arthrodesis. The purpose of this study was to evaluate the in vitro biomechanical performance of the axial fixation rod, an anulus sparing, centrally placed interbody fusion implant for motion segment stabilization. Method of Approach: Twenty-four bovine lumbar motion segments were mechanically tested using an unconstrained flexibility protocol in sagittal and lateral bending, and torsion. Motion segments were also tested in axial compression. Each specimen was tested in an intact state, then drilled (simulating a transaxial approach to the lumbosacral spine), then with one of two axial fixation rods placed in the spine for stabilization. The range of motion, bending stiffness, and axial compressive stiffness were determined for each test condition. Results were compared to those previously reported for femoral ring allografts, bone dowels, BAK and BAK Proximity cages, Ray TFC, Brantigan ALIF and TLIF implants, the InFix Device, Danek TIBFD, single and double Harms cages, and Kaneda, Isola, and University plating systems. Results: While axial drilling of specimens had little effect on stiffness and range of motion, specimens implanted with the axial fixation rod exhibited significant increases in stiffness and decreases in range of motion relative to intact state. When compared to existing anterior, posterior, and interbody instrumentation, lateral and sagittal bending stiffness of the axial fixation rod exceeded that of all other interbody devices, while stiffness in extension and axial compression were comparable to plate and rod constructs. Torsional stiffness was comparable to other interbody constructs and slightly lower than plate and rod constructs. Conclusions: For stabilization of the L5-S1 motion segment, axial placement of implants offers potential benefits relative to traditional exposures. The preliminary biomechanical data from this study indicate that the axial fixation rod compares favorably to other devices and may be suitable to reduce pathologic motion at L5-S1, thus promoting bony fusion.

2017 ◽  
Vol 27 (5) ◽  
pp. 570-577 ◽  
Author(s):  
Mohamed Macki ◽  
Rafael De la Garza-Ramos ◽  
Ashley A. Murgatroyd ◽  
Kenneth P. Mullinix ◽  
Xiaolei Sun ◽  
...  

OBJECTIVEAggressive sacral tumors often require en bloc resection and lumbopelvic reconstruction. Instrumentation failure and pseudarthrosis remain a clinical concern to be addressed. The objective in this study was to compare the biomechanical stability of 3 distinct techniques for sacral reconstruction in vitro.METHODSIn a human cadaveric model study, 8 intact human lumbopelvic specimens (L2–pelvis) were tested for flexion-extension range of motion (ROM), lateral bending, and axial rotation with a custom-designed 6-df spine simulator as well as axial compression stiffness with the MTS 858 Bionix Test System. Biomechanical testing followed this sequence: 1) intact spine; 2) sacrectomy (no testing); 3) Model 1 (L3–5 transpedicular instrumentation plus spinal rods anchored to iliac screws); 4) Model 2 (addition of transiliac rod); and 5) Model 3 (removal of transiliac rod; addition of 2 spinal rods and 2 S-2 screws). Range of motion was measured at L4–5, L5–S1/cross-link, L5–right ilium, and L5–left ilium.RESULTSFlexion-extension ROM of the intact specimen at L4–5 (6.34° ± 2.57°) was significantly greater than in Model 1 (1.54° ± 0.94°), Model 2 (1.51° ± 1.01°), and Model 3 (0.72° ± 0.62°) (p < 0.001). Flexion-extension at both the L5–right ilium (2.95° ± 1.27°) and the L5–left ilium (2.87° ± 1.40°) for Model 3 was significantly less than the other 3 cohorts at the same level (p = 0.005 and p = 0.012, respectively). Compared with the intact condition, all 3 reconstruction groups statistically significantly decreased lateral bending ROM at all measured points. Axial rotation ROM at L4–5 for Model 1 (2.01° ± 1.39°), Model 2 (2.00° ± 1.52°), and Model 3 (1.15° ± 0.80°) was significantly lower than the intact condition (5.02° ± 2.90°) (p < 0.001). Moreover, axial rotation for the intact condition and Model 3 at L5–right ilium (2.64° ± 1.36° and 2.93° ± 1.68°, respectively) and L5–left ilium (2.58° ± 1.43° and 2.93° ± 1.71°, respectively) was significantly lower than for Model 1 and Model 2 at L5–right ilium (5.14° ± 2.48° and 4.95° ± 2.45°, respectively) (p = 0.036) and L5–left ilium (5.19° ± 2.34° and 4.99° ± 2.31°) (p = 0.022). Last, results of the axial compression testing at all measured points were not statistically different among reconstructions.CONCLUSIONSThe addition of a transverse bar in Model 2 offered no biomechanical advantage. Although the implementation of 4 iliac screws and 4 rods conferred a definitive kinematic advantage in Model 3, that model was associated with significantly restricted lumbopelvic ROM.


1998 ◽  
Vol 11 (02) ◽  
pp. 100-104 ◽  
Author(s):  
R. A. Read ◽  
R. Day ◽  
M. J. Thomson

SummaryDistal radial osteotomies were performed in 20 limbs from ten cadaver specimens. Ten bones were stabilised with two × 1.6 mm surgical bone staples and ten were stabilised with a 2.7 mm T platea. The radii were removed and the osteotomies were biomechanically tested in torsion initially, and then to failure in bending. Statistically significant differences were not found between the two types of repair in torsional stiffness, bending stiffness, deflection to failure in bending, or load to failure in bending. Orthopaedic staples are a simple, cost-effective alternative to bone plates for stabilisation of distal radial osteotomies.Bilateral distal radial osteotomies were created in dog cadavers and then repaired with either two bone staples or a 2.7 mm T plate. The limbs were then tested in vitro to compare the relative strengths of the repairs in torsion and bending. Statistically significant differences were not found between the two methods of stabilisation.


2021 ◽  
pp. 219256822110060
Author(s):  
Jun-Xin Chen ◽  
Yun-He Li ◽  
Jian Wen ◽  
Zhen Li ◽  
Bin-Sheng Yu ◽  
...  

Study Design: A biomechanical study. Objectives: The purpose of this study was to investigate the effects of cruciform and square incisions of annulus fibrosus (AF) on the mechanical stability of bovine intervertebral disc (IVD) in multiple degrees of freedom. Methods: Eight bovine caudal IVD motion segments (bone-disc-bone) were obtained from the local abattoir. Cruciform and square incisions were made at the right side of the specimen’s annulus using a surgical scalpel. Biomechanical testing of three-dimensional 6 degrees of freedom was then performed on the bovine caudal motion segments using the mechanical testing and simulation (MTS) machine. Force, displacement, torque and angle were recorded synchronously by the MTS system. P value <.05 was considered statistically significant. Results: Cruciform and square incisions of the AF reduced both axial compressive and torsional stiffness of the IVD and were significantly lower than those of the intact specimens ( P < .01). Left-side axial torsional stiffness of the cruciform incision was significantly higher than a square incision ( P < .01). Neither incision methods impacted flexional-extensional stiffness or lateral-bending stiffness. Conclusions: The cruciform and square incisions of the AF obviously reduced axial compression and axial rotation, but they did not change the flexion-extension and lateral-bending stiffness of the bovine caudal IVD. This mechanical study will be meaningful for the development of new approaches to AF repair and the rehabilitation of the patients after receiving discectomy.


2012 ◽  
Vol 248 ◽  
pp. 69-73 ◽  
Author(s):  
Shu Ming Chen ◽  
Xue Wei Song ◽  
Chuan Liang Shen ◽  
Deng Feng Wang ◽  
Wei Li

In order to know the static stiffness characteristics of the vehicle body in white, the bending stiffness and torsional stiffness of an automotive body in white were tested on a test bench of the static stiffness of an automotive BIW. The bending stiffness and bending deformation of the bottom of the BIW were determined. Also, the torsional stiffness and torsional deformation of the bottom of the BIW were obtained. The fitting curves and equations between loading torque and torsional angle were acquired at clockwise and counterclockwise loading, respectively.


Author(s):  
Philip Boughton ◽  
James Merhebi ◽  
C. Kim ◽  
G. Roger ◽  
Ashish D. Diwan ◽  
...  

An elastomeric spinal disk prosthesis design (BioFI™) with vertebral interlocking anchors has been modified using an embedded TiNi wire array. Bioinert styrenic block copolymer (Kraton®) and polycarbonate urethane (Bionate®) thermoplastic elastomer (TPE) matrices were utilized. Fatigue resistant NiTi wire was pretreated to induce superelastic martensitic microstructure. Stent-like helical structures were produced for incorporation within homogenous TPE matrix. Composite prototypes were fabricated in a vacuum hot press using transfer moulding techniques. Implant prototypes were subject to axial compression using a BOSE ® ELF3400. The NiTi reinforced implants exhibited reduction in axial strain, compliance, and creep compared to TPE controls. The axial properties of the NiTi reinforced Bionate® BioFI™ implant best approximated those of a spinal disk followed by Kraton®-NiTi, Bionate® and Kraton® prototypes. An ovine lumbar segment biomechanical model was used to characterize the disk prosthesis prototypes. Specimens were subject to 7.5Nm pure moments in axial rotation, flexion-extension and lateral bending with a custom jig mounted on an Instron® 8874. The motion preserving ligamentous nature of this arthroplasty prototype was not inhibited by NiTi reinforcement. Joint stiffness for all prototypes was significantly less than the intact and discectomy controls. This was due to lack of vertebral anchor rigidity rather than BioFI™ motion segment matrix type or reinforcement. Implant stress profiles for axial compression and axial torsion conditions were obtained using finite element methods. The biomechanical testing and finite element modelling both support existing BioFI™ design specifications for higher modulus vertebral anchors, endplates and motion segment periphery with gradation to a low modulus core within the motion segment. This closer approximation of the native spinal disk form translates to improvements in prosthesis biomechanical fidelity and longevity. Axial compressive strain induced within a TiNi reinforced Kraton® BioFI™ was found to be linearly proportional to the NiTi helical coil electrical resistance. This neural network capability delivers opportunities to monitor and telemeterize in situ multiaxis joint structural performance and in vivo spine biomechanics.


2013 ◽  
Vol 368-370 ◽  
pp. 1426-1430
Author(s):  
Li Xiong Gu ◽  
Rong Hui Wang

In this paper, by establishing the finite element model to study the dynamic characteristics of rigid frame single-rib arch bridge. By respectively changing structural parameters of the span ratios, and the compressive stiffness of arch, and the bending stiffness of arch, and the bending stiffness of bridge girder, and the layout of boom to find out the regularity of the structure on lateral stiffness, and vertical stiffness, and torsional stiffness as well as dynamic properties, it come out the results of that lateral stiffness of the structure is weaker, and increasing the span ratios and the compressive strength of arch are conducive to the improvement of the overall stiffness, and improving the bending strength of arch and layout of boom are less effect on the overall stiffness and mode shape.


2013 ◽  
Vol 46 (7) ◽  
pp. 1369-1375 ◽  
Author(s):  
Brian P. Kelly ◽  
Nephi A. Zufelt ◽  
Elizabeth J. Sander ◽  
Denis J. DiAngelo

2017 ◽  
Vol 7 (3) ◽  
pp. 239-245 ◽  
Author(s):  
Nitin Bhatia ◽  
Asheen Rama ◽  
Brandon Sievers ◽  
Ryan Quigley ◽  
Michelle H. McGarry ◽  
...  

Study Design: Biomechanical, cadaveric study. Objectives: To compare the relative stiffness of unilateral C1 lateral mass-C2 intralaminar fixation to intact specimens and bilateral C1 lateral mass-C2 intralaminar constructs. Methods: The biomechanical integrity of a unilateral C1 lateral mass-C2 intralaminar screw construct was compared to intact specimens and bilateral C1 lateral mass-C2 intralaminar screw constructs. Five human cadaveric specimens were used. Range of motion and stiffness were tested to determine the stiffness of the constructs. Results: Unilateral fixation significantly decreased flexion/extension range of motion compared to intact ( P < .001) but did not significantly affect axial rotation ( P = .3) or bending range of motion ( P = .3). There was a significant decrease in stiffness in extension for both unilateral and bilateral fixation techniques compared to intact ( P = .04 and P = .03, respectively). There was also a significant decrease in stiffness for ipsilateral rotation for the unilateral construct compared to intact ( P = .007) whereas the bilateral construct significantly increased ipsilateral rotation stiffness compared to both intact and unilateral fixation ( P < .001). Conclusion: Bilateral constructs did show improved biomechanical properties compared to the unilateral constructs. However, unilateral C1-C2 fixation using a C1 lateral mass and C2 intralaminar screw-rod construct decreased range of motion and improved stiffness compared to the intact state with the exception of extension and ipsilateral rotation. Hence, a unilateral construct may be acceptable in clinical situations in which bilateral fixation is not possible, but an external orthosis may be necessary to achieve a fusion.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250456
Author(s):  
Robin Remus ◽  
Andreas Lipphaus ◽  
Marc Neumann ◽  
Beate Bender

In computational biomechanics, two separate types of models have been used predominantly to enhance the understanding of the mechanisms of action of the lumbosacral spine (LSS): Finite element (FE) and musculoskeletal multibody (MB) models. To combine advantages of both models, hybrid FE-MB models are an increasingly used alternative. The aim of this paper is to develop, calibrate, and validate a novel passive hybrid FE-MB open-access simulation model of a ligamentous LSS using ArtiSynth. Based on anatomical data from the Male Visible Human Project, the LSS model is constructed from the L1-S1 rigid vertebrae interconnected with hyperelastic fiber-reinforced FE intervertebral discs, ligaments, and facet joints. A mesh convergence study, sensitivity analyses, and systematic calibration were conducted with the hybrid functional spinal unit (FSU) L4/5. The predicted mechanical responses of the FSU L4/5, the lumbar spine (L1-L5), and the LSS were validated against literature data from in vivo and in vitro measurements and in silico models. Spinal mechanical responses considered when loaded with pure moments and combined loading modes were total and intervertebral range of motions, instantaneous axes and centers of rotation, facet joint contact forces, intradiscal pressures, disc bulges, and stiffnesses. Undesirable correlations with the FE mesh were minimized, the number of crisscrossed collagen fiber rings was reduced to five, and the individual influences of specific anatomical structures were adjusted to in vitro range of motions. Including intervertebral motion couplings for axial rotation and nonlinear stiffening under increasing axial compression, the predicted kinematic and structural mechanics responses were consistent with the comparative data. The results demonstrate that the hybrid simulation model is robust and efficient in reproducing valid mechanical responses to provide a starting point for upcoming optimizations and extensions, such as with active skeletal muscles.


2021 ◽  
Vol 29 (5) ◽  
pp. 246-248
Author(s):  
GUILHERME GUADAGNINI FALOTICO ◽  
VALÉRIA ROMERO ◽  
RICARDO BASILE ◽  
EDMILSON TAKEHIRO TAKATA

ABSTRACT Objective: To date, the literature lacks consensus on the most efficient method to measure the range of motion of an in vitro prosthetic system. In this study, we propose the use of a relatively low-cost online software to measure the range of motion of hip prosthetic implants manufactured in Brazil and compare its results with the current technical standards for hip arthroplasty. Methods: Three different diameters of femoral heads were evaluated (28 mm, 32 mm, and 36 mm). The mean values of the angular displacement of the prosthesis in each motion axis were obtained by computer simulations. Results: The range of motion with each femoral head was 28mm (extension/flexion: 148°, internal/external rotation: 179°, adduction/abduction: 107°), 32 mm (152°/185°/114°), and 36 mm (158°/193°/120°). Conclusion: The computational method showed that the larger the femoral head, the greater the range of motion of the hip joint prosthetic system. Additional clinical studies are necessary to compare the physical results obtained with the values found in this study by computational modeling. Level of evidence V, Experimental study.


Sign in / Sign up

Export Citation Format

Share Document