title: A novel approach for biomechanical spine analysis: Mechanical response of vertebral bone augmentation by kyphoplasty to stabilise thoracolumbar burst fractures.
abstract: Kyphoplasty has been shown as a well-established technique for spinal injuries. This technique allows a vertebral bone augmentation with a reduction of morbidity and does not involve any adjacent segment immobilisation. There is a lack of biomechanical information resulting in major gaps of knowledge such as: the evaluation of the "quality" of stabilisation provided by kyphoplasty as a standalone procedure in case of unstable fracture. Our objective is to analyse biomechanical response of spine segments stabilised by Kyphoplasty and PMMA cement after experiencing burst fractures. Six fresh-frozen cadaveric spine specimens constituted by five vertebra (T11-L3) and four disks were tested. A specific loading setup has been developed to impose pure moments corresponding to loadings of flexion-extension, lateral bending and axial rotation. Tests were performed on each specimen in an intact state and post kyphoplasty following a burst fracture. Strain measurements and motion variations of spinal unit are measured by a 3D optical method. Strain measurements on vertebral bodies after kyphoplasty shows a great primary stabilisation. Comparisons of mobility and angles variations between the intact and post kyphoplasty states do not highlight significant difference. Percutaneous kyphoplasty offers a good primary stability in case of burst fracture. Kinematics analysis during physiological movements shows that this stabilisation solution preserve disk mobility in each adjacent spinal unit.
authors.affiliation: Institut Pprime UPR 3346, CNRS - University of Poitiers - ISAE-ENSMA, France. Electronic address: arnaud.germaneau@univ-poitiers.fr.
authors.forename: A
authors.initials: A
authors.lastname: Germaneau
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, University Hospital, Poitiers, France; Spine-Neurostimulation Unit, N3 Lab, University Hospital, Poitiers, France.
authors.forename: T
authors.initials: T
authors.lastname: Vendeuvre
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, University Hospital, Poitiers, France.
authors.forename: M
authors.initials: M
authors.lastname: Saget
authors.affiliation: Institut Pprime UPR 3346, CNRS - University of Poitiers - ISAE-ENSMA, France.
authors.forename: P
authors.initials: P
authors.lastname: Doumalin
authors.affiliation: Institut Pprime UPR 3346, CNRS - University of Poitiers - ISAE-ENSMA, France.
authors.forename: J C
authors.initials: JC
authors.lastname: Dupré
authors.affiliation: Institut Pprime UPR 3346, CNRS - University of Poitiers - ISAE-ENSMA, France.
authors.forename: F
authors.initials: F
authors.lastname: Brémand
authors.affiliation: Institut Pprime UPR 3346, CNRS - University of Poitiers - ISAE-ENSMA, France.
authors.forename: F
authors.initials: F
authors.lastname: Hesser
authors.affiliation: Institut Pprime UPR 3346, CNRS - University of Poitiers - ISAE-ENSMA, France.
authors.forename: M
authors.initials: M
authors.lastname: Couvertier
authors.affiliation: Institut Pprime UPR 3346, CNRS - University of Poitiers - ISAE-ENSMA, France; Laboratory of Anatomy, University of Poitiers, France.
authors.forename: C
authors.initials: C
authors.lastname: Brèque
authors.affiliation: Medtronic International Trading Sarl, Tolochenaz, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Maxy
authors.affiliation: Spine-Neurostimulation Unit, N3 Lab, University Hospital, Poitiers, France.
authors.forename: M
authors.initials: M
authors.lastname: Roulaud
authors.affiliation: Spine-Neurostimulation Unit, N3 Lab, University Hospital, Poitiers, France.
authors.forename: O
authors.initials: O
authors.lastname: Monlezun
authors.affiliation: Spine-Neurostimulation Unit, N3 Lab, University Hospital, Poitiers, France.
authors.forename: P
authors.initials: P
authors.lastname: Rigoard
mesh_terms: D001696:Biomechanical Phenomena; D001843:Bone Cements; D002102:Cadaver; D006801:Humans; D058498:Kyphoplasty; D008159:Lumbar Vertebrae / Q000601:surgery*; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*
chemical_list: D001843:Bone Cements
keywords: Biomechanics; Burst fracture; Optical methods; Thoracolumbar spine