Biomechanical Comparison of Subsidence Between Patient-Specific and Non-Patient-Specific Lumbar Interbody Fusion Cages

Study Design Biomechanical study. Objectives Several strategies to improve the surface of contact between an interbody device and the endplate have been employed to attenuate the risk of cage subsidence. 3D-printed patient-specific cages have been presented as a promising alternative to help mitigat...

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Veröffentlicht in:Global spine journal 2024-05, Vol.14 (4), p.1155-1163
Hauptverfasser: Fernandes, Renan J.R., Gee, Aaron, Kanawati, Andrew J., Siddiqi, Fawaz, Rasoulinejad, Parham, Zdero, Radovan, Bailey, Christopher S.
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container_end_page 1163
container_issue 4
container_start_page 1155
container_title Global spine journal
container_volume 14
creator Fernandes, Renan J.R.
Gee, Aaron
Kanawati, Andrew J.
Siddiqi, Fawaz
Rasoulinejad, Parham
Zdero, Radovan
Bailey, Christopher S.
description Study Design Biomechanical study. Objectives Several strategies to improve the surface of contact between an interbody device and the endplate have been employed to attenuate the risk of cage subsidence. 3D-printed patient-specific cages have been presented as a promising alternative to help mitigate that risk, but there is a lack of biomechanical evidence supporting their use. We aim to evaluate the biomechanical performance of 3D printed patient-specific lumbar interbody fusion cages in relation to commercial cages in preventing subsidence. Methods A cadaveric model is used to investigate the possible advantage of 3D printed patient-specific cages matching the endplate contour using CT-scan imaging in preventing subsidence in relation to commercially available cages (Medtronic Fuse and Capstone). Peak failure force and stiffness were analyzed outcomes for both comparison groups. Results PS cages resulted in significantly higher construct stiffness when compared to both commercial cages tested (>59%). PS cage peak failure force was 64% higher when compared to Fuse cage (P < .001) and 18% higher when compared to Capstone cage (P = .086). Conclusions Patient-specific cages required higher compression forces to produce failure and increased the cage-endplate construct' stiffness, decreasing subsidence risk.
doi_str_mv 10.1177/21925682221134913
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Objectives Several strategies to improve the surface of contact between an interbody device and the endplate have been employed to attenuate the risk of cage subsidence. 3D-printed patient-specific cages have been presented as a promising alternative to help mitigate that risk, but there is a lack of biomechanical evidence supporting their use. We aim to evaluate the biomechanical performance of 3D printed patient-specific lumbar interbody fusion cages in relation to commercial cages in preventing subsidence. Methods A cadaveric model is used to investigate the possible advantage of 3D printed patient-specific cages matching the endplate contour using CT-scan imaging in preventing subsidence in relation to commercially available cages (Medtronic Fuse and Capstone). Peak failure force and stiffness were analyzed outcomes for both comparison groups. Results PS cages resulted in significantly higher construct stiffness when compared to both commercial cages tested (&gt;59%). PS cage peak failure force was 64% higher when compared to Fuse cage (P &lt; .001) and 18% higher when compared to Capstone cage (P = .086). Conclusions Patient-specific cages required higher compression forces to produce failure and increased the cage-endplate construct' stiffness, decreasing subsidence risk.</description><identifier>ISSN: 2192-5682</identifier><identifier>EISSN: 2192-5690</identifier><identifier>DOI: 10.1177/21925682221134913</identifier><identifier>PMID: 36259252</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Biomechanics ; Original</subject><ispartof>Global spine journal, 2024-05, Vol.14 (4), p.1155-1163</ispartof><rights>The Author(s) 2022</rights><rights>The Author(s) 2022. This work is licensed under the Creative Commons Attribution – Non-Commercial – No Derivatives License https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2022 2022 AO Spine, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-dbbadc3d592d0fb8af0855c5884f27ca8669792dfe6e87e93cd17def1bd7584c3</citedby><cites>FETCH-LOGICAL-c467t-dbbadc3d592d0fb8af0855c5884f27ca8669792dfe6e87e93cd17def1bd7584c3</cites><orcidid>0000-0002-6696-764X ; 0000-0002-4188-1882</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289543/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289543/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,21973,27860,27931,27932,44952,45340,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36259252$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fernandes, Renan J.R.</creatorcontrib><creatorcontrib>Gee, Aaron</creatorcontrib><creatorcontrib>Kanawati, Andrew J.</creatorcontrib><creatorcontrib>Siddiqi, Fawaz</creatorcontrib><creatorcontrib>Rasoulinejad, Parham</creatorcontrib><creatorcontrib>Zdero, Radovan</creatorcontrib><creatorcontrib>Bailey, Christopher S.</creatorcontrib><title>Biomechanical Comparison of Subsidence Between Patient-Specific and Non-Patient-Specific Lumbar Interbody Fusion Cages</title><title>Global spine journal</title><addtitle>Global Spine J</addtitle><description>Study Design Biomechanical study. Objectives Several strategies to improve the surface of contact between an interbody device and the endplate have been employed to attenuate the risk of cage subsidence. 3D-printed patient-specific cages have been presented as a promising alternative to help mitigate that risk, but there is a lack of biomechanical evidence supporting their use. We aim to evaluate the biomechanical performance of 3D printed patient-specific lumbar interbody fusion cages in relation to commercial cages in preventing subsidence. Methods A cadaveric model is used to investigate the possible advantage of 3D printed patient-specific cages matching the endplate contour using CT-scan imaging in preventing subsidence in relation to commercially available cages (Medtronic Fuse and Capstone). Peak failure force and stiffness were analyzed outcomes for both comparison groups. Results PS cages resulted in significantly higher construct stiffness when compared to both commercial cages tested (&gt;59%). PS cage peak failure force was 64% higher when compared to Fuse cage (P &lt; .001) and 18% higher when compared to Capstone cage (P = .086). 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title Biomechanical Comparison of Subsidence Between Patient-Specific and Non-Patient-Specific Lumbar Interbody Fusion Cages
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