Biomechanical studies of the anterior spinal fixators after corpectomy in pigs.
An unstable corpectomy porcine spinal model was created for the testing of anterior spinal fixators including: Kaneda device (KD), combination of Polster-Brinckmann prosthesis and Zielke implant (PBZ), and a new prototype device (CH). These spinal implants were examined in a one above/one below corpectomy model to determine the relative stiffness of each construct and the deformation of the adjacent discs under loading. The results indicated that the relative torsion and flexion stiffness were higher for the tested spines fixed with KD and CH. However, the relative compression stiffness of the tested spines was the same for all devices. The rigidity of the spinal constructs, which were measured around the corpectomy region showed the same tendency as above. However, the stiffness of CH and KD constructs were significantly higher than that of the PBZ construct under flexion and torsion. The difference in deformation of the upper and lower adjacent discs was not obvious among the intact spine and the spinal constructs with different devices. Clinical relevances: The corpectomy model represents a "worst case" scenario of spinal instability. In many conditions, spinal reconstructive surgery can restore axial compressive, torsional, and flexural rigidity to normal levels. These experimental conclusions apply to acute restoration of stability, rather than to rigidity after long-term cyclical loading. These three anterior fixators extended to only one cephalad level and one caudal level beyond the corpectomy defect. The new prototype device (CH) has a stability to the Kaneda device. The superior mechanical strength and simpler operative procedure of the new device provide for a potential clinical advantage in restoration of unstable spinal conditions.
Chen
P Q
PQ
Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, R.O.C.
Wu
C M
CM
Jao
W T
WT
Shih
C M
CM
Cheng
C K
CK
D000818:Animals; D001696:Biomechanical Phenomena; D001843:Bone Cements; D016267:External Fixators / Q000592:standards; D005592:Fracture Fixation / Q000295:instrumentation; D006168:Guinea Pigs; D016268:Internal Fixators / Q000592:standards; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery; D008954:Models, Biological; D009984:Orthopedic Fixation Devices / Q000592:standards*; D019736:Prostheses and Implants; D016103:Spinal Fractures / Q000503:physiopathology / Q000601:surgery*; D013131:Spine / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery
D001843:Bone Cements