scholarly journals Bioabsorbable self-retaining PLA/nano-sized β-TCP cervical spine interbody fusion cage in goat models: an in vivo study

2017 ◽  
Vol Volume 12 ◽  
pp. 7197-7205 ◽  
Author(s):  
Lu Cao ◽  
Qian Chen ◽  
Li-Bo Jiang ◽  
Xiao-Fan Yin ◽  
Chong Bian ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Interbody Fusion ◽  
In Vivo Study ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Anwendung eines Bandscheibenersatzimplantats aus einer neuartigen porösen TiO2/Glas-Keramik – Teil 1: Einsatz in der Schafs-Halswirbelsäule und radiologische Verlaufsuntersuchungen / Application of a Stand-Alone Interbody Fusion Cage Based on a Novel Porous TiO2/glass Composite – Part 1: Implantation in the Sheep Cervical Spine and Radiological Evaluation

2004 ◽  
Vol 49 (12) ◽  
Author(s):  
M. C Korinth ◽  
T Hero ◽  
A. H Mahnken ◽  
C Ragoß ◽  
K Scherer
Keyword(s):  
Cervical Spine ◽  
Interbody Fusion ◽  
Porous Ceramic ◽  
In Vivo Models ◽  
Bone Replacement ◽  
Radiological Changes ◽  
Fusion Cage ◽  
Interbody Fusion Cage

AbstractZur Beurteilung des radiologischen, biomechanischen und histologischen Einwachsverhaltens neuer Materialien, Implantate und Cages für die zervikale interkorporelle Fusion, bieten sich Tiermodelle und hier insbesondere das Schafs-Halswirbelsäulenmodell an.In biomechanischen In-vitro-Versuchen an humanen Kadaver-Halswirbelsäulen wurden erste Erfahrungen hinsichtlich Primärstabilität eines Cage aus einer neuartigen, porösen TiOZur entsprechenden In-vivo-Beurteilung fusionierten wir 10 Schafs-Halswirbelsäulen in den Höhen C2/3 und C4/5 jeweils mit PMMA und einem Ecopore-Keramik-Cage und führten nativradiologische, sowie computertomographische Verlaufsuntersuchungen direkt post-operativ und alle 4 Wochen in den folgenden 2 bzw. 4 Monaten durch. Neben der Etablierung des Tiermodells, wurden die radiologischen Veränderungen im Verlauf und die Fusion der operierten Segmente analysiert. Darüberhinaus wurden Messungen der entsprechenden Bandscheibenfachhöhen (DSH) und Intervertebralwinkel (IVA) durchgeführt und verglichen.Nach Einbringen der Implantate in die Bandscheibenfächer nahm zunächst in beiden Gruppen die mittlere Bandscheibenfachhöhe und der Intervertebralwinkel zu (34,8%; 53,9%). In den folgenden Monaten verringerte sich die Bandscheibenfachhöhe nicht signifikant, deutlicher nach Ecopore-Fusion als nach PMMA-Interposition bis auf Werte unterhalb der Ausgangswerte. Ebenso nahm der Intervertebralwinkel im postoperativen Verlauf, deutlicher in der Ecopore-Gruppe als in der PMMA-Gruppe, ab (p < 0,05). Diese Veränderungen im Sinne einer Einsinterung der Implantate, konnte in den radiologischen Verlaufskontrollen morphologisch bestätigt werden. Die radiologisch beurteilbare Fusion, d.h. solide knöcherne Überbauung des operierten Segments, war nach Implantation eines Ecopore-Cage ausgeprägter (83%) als nach PMMA-Interposition (50%) (nicht statistisch signifikant).In diesem ersten Teil unserer In-vivo-Untersuchungen zu dem Einsatz des neuartigen Cage-Materials wurde die Anwendung im Spondylodesemodell der Schafs-Halswirbelsäule aufgezeigt. Es zeigten sich radiologische Unterschiede, in Bezug auf die ausgeprägtere Einsinterung des Ecopore-Cage und die deutlichere, nachweisbare Fusion des mit dem neuen Material operierten Segments. In dem ersten Teil dieser Studie wurden die radiologischen Veränderungen der fusionierten Segmente über mehrere Monate dargestellt und morphologisch analysiert, bevor die biomechanischen Analysen und Vergleiche in einem weiteren Teil präsentiert werden sollen. Animals are becoming more and more common as in vitro and in vivo models for the human spine. Especially the sheep cervical spine is stated to be of good comparability and usefulness in the evaluation of in vivo radiological, biomechanical and histological behaviour of new bone replacement materials, implants and cages for cervical spine interbody fusion.In preceding biomechanical in vitro examination human cervical spine specimens were tested after fusion with either a cubical stand-alone interbody fusion cage manufactured from a new porous TiOImmediately after placement of both implants in the disc spaces the mean DSH and IVA increased (34.8% and 53.9%, respectively). During the following months DSH decreased to a greater extent in the Ecopore-segments than in the PMMA-segments, even to a value below the initial value (p > 0,05). Similarly, the IVA decreased in both groups in the postoperative time lapse, but more distinct in the Ecopore-segments (p < 0,05). These changes in terms of a subsidence of the implants, were confirmed morphologically in the radiological examination in the course. The radiologically evaluated fusion, i.e. bony bridging of the operated segments, was more pronounced after implantation of an Ecopore-cage (83%), than after PMMA interposition (50%), but did not gain statistical significance.In this first in vivo examination of our new porous ceramic bone replacement material we showed its application in the spondylodesis model of the sheep cervical spine. Distinct radiological changes regarding evident subsidence and detectable fusion of the segments, operated on with the new biomaterial, were seen. We demonstrated the radiological changes of the fused segments during several months and analysed them morphologically, before the biomechanical evaluation will be presented in a subsequent publication.

Biomechanical comparison of transdiscal fixation and posterior fixation with and without transforaminal lumbar interbody fusion in the treatment of L5–S1 lumbosacral joint

2018 ◽  
Vol 232 (4) ◽  
pp. 371-377 ◽  
Author(s):  
Hakan Özalp ◽  
Mustafa Özkaya ◽  
Onur Yaman ◽  
Teyfik Demir
Keyword(s):  
Pedicle Screw ◽  
Axial Compression ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Posterior Fixation ◽  
Lumbar Interbody Fusion ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Transdiscal screw fixation is generally performed in the treatment of high-grade L5–S1 spondylolisthesis. The main thought of the study is that the biomechanical performances of the transdiscal pedicle screw fixation can be identical to standard posterior pedicle screw fixations with or without transforaminal lumbar interbody fusion cage insertion. Lumbosacral portions and pelvises of 45 healthy lambs’ vertebrae were dissected. Animal cadavers were randomly and equally divided into three groups for instrumentation. Three fixation systems, L5–S1 posterior pedicle screw fixation, L5–S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion, and L5–S1 transdiscal pedicle screw fixation, were generated. Axial compression, flexion, and torsion tests were conducted on test samples of each system. In axial compression, L5–S1 transdiscal fixation was less stiff than L5–S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion. There were no significant differences between groups in flexion. Furthermore, L5–S1 posterior fixation was stiffest under torsional loads. When axial compression and flexion loads are taken into consideration, transdiscal fixation can be alternatively used instead of posterior pedicle screw fixation in the treatment of L5–S1 spondylolisthesis because it satisfies enough stability. However, in torsion, posterior fixation is shown as a better option due to its higher stiffness.

Design and Research of Interspinous Lumbar Non-Fusion Device

2010 ◽  
Author(s):  
Lei Li ◽  
Zhaohua Chang ◽  
Xuelian Gu ◽  
Chengli Song
Keyword(s):  
Stress Concentration ◽  
Vertebral Body ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Pedicle Screws ◽  
Adjacent Level ◽  
Flexion Extension ◽  
Fusion Cage ◽  
Adjacent Level Degeneration ◽  
Interbody Fusion Cage

Objective: Long term clinical data showed that lumbar fusion for Lumbar spinal stenosis (LSS) and lumbar disc degeneration (LDD) therapy could change the loads of disc and articular facet and increase the motion of adjacent segments which lead to facet arthropathy and adjacent level degeneration. This study is to design and analyze an interspinous process device (IPD) that could prevent adjacent level degeneration in the LSS and LDD therapy. Method: The IPD was designed based on anatomical parameters measured from 3D CT images directly. The IPD was inserted at the validated finite element model of the mono-segmental L3/L4. The biomechanical performance of a pair of interbody fusion cages and a paired pedicel screws were studied to compare with the IPD. The model was loaded with the upper body weight and muscle forces to simulate five loading cases including standing, compression, flexion, extension, lateral bending and axial rotation. Results: The interbody fusion cage induced serious stress concentration on the surface of vertebral body, has the worst biomechanical performance among the three systems. Pedicle screws and interbody fusion cage could induce stress concentration within vertebral body which leads to vertebral compression fracture or screw loosening. Regarding to disc protection, the IPD had higher percentage to share the load of posterior lumbar structure than the pedicel screws and interbody fusion cage. Conclusion: IPD has the same loads as pedicle screw-rod which suggests it has a good function in the posterior stability. While the IPD had much less influence on vertebral body. Furthermore, IPD could share the load of intervertebral discs and facet joints to maintain the stability of lumbar spine.

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