title: Mechanical Contribution of the Rib Cage in the Human Cadaveric Thoracic Spine.
abstract: METHODS
  An in vitro biomechanical human cadaveric study of T1-T12 thoracic specimens was performed with 4 conditions (with and without rib cage, instrumented and uninstrumented) in flexion-extension, lateral bending, and axial rotation.
  
  
  OBJECTIVE
  The objective was to understand the influence of the rib cage on motion and stiffness parameters of the human cadaveric thoracic spine. Hypotheses tested for overall motion in all modes of bending for both uninstrumented and instrumented specimens were (i) in-plane range of motion and neutral and elastic zones will be greater without the rib cage, (ii) neutral and elastic zone stiffness values will be different for specimens without the rib cage, and (iii) out-of-plane rotations will be different for specimens without the rib cage.
  
  
  BACKGROUND
  The rib cage is presumed to provide significant stability to the thoracic spine, but no studies have been conducted to determine the influence of the rib cage in both uninstrumented and instrumented conditions in the full thoracic human cadaveric specimens.
  
  
  METHODS
  Seven human cadaveric spine specimens (T1-T12) with 4 conditions (with and without rib cage, instrumented and uninstrumented) were subjected to 5 N·m pure moments in flexion-extension, lateral bending, and axial rotation. Range of motion, neutral and elastic zones, neutral and elastic zone stiffness values, and out-of-plane rotations were calculated for the overall specimen.
  
  
  RESULTS
  In-plane range of motion was significantly higher without a rib cage for most modes of bending. Out-of-plane motions were also influenced by the rib cage. Neutral zone stiffness was significantly higher with a rib cage present.
  
  
  CONCLUSIONS
  Testing without a rib cage yields different motion and stiffness measures, directly impacting the translation of research results to clinical interpretation. Researchers should consider these differences when evaluating the mechanical impact of surgical procedures or instrumentation in cadaveric or computational models.
  
  
  METHODS
  5.
authors.affiliation: *Department of Mechanical Engineering, The University of Kansas, Lawrence, KS †Department of Orthopaedic Surgery, Children's Mercy Hospital and Clinics of Kansas City, Kansas City, MO; and ‡Department of Neurosurgery, University of Kansas Medical Center, Kansas City, KS.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Mannen
authors.forename: John T
authors.initials: JT
authors.lastname: Anderson
authors.forename: Paul M
authors.initials: PM
authors.lastname: Arnold
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Friis
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D001858:Bone Nails; D002102:Cadaver; D004548:Elasticity; D006801:Humans; D008875:Middle Aged; D010027:Osteotomy; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation; D016059:Range of Motion, Articular; D012272:Ribs / Q000033:anatomy & histology / Q000502:physiology* / Q000601:surgery; D012399:Rotation; D013904:Thoracic Vertebrae / Q000033:anatomy & histology / Q000502:physiology* / Q000601:surgery