Journal article
Biomechanical testing of a PEEK-based dynamic instrumentation device in a lumbar spine model.
- Herren C Department for Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany. Electronic address: cherren@ukaachen.de.
- Beckmann A Institute of General Mechanics, RWTH Aachen, Templergraben 64, 52062 Aachen, Germany.
- Meyer S Department for Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
- Pishnamaz M Department for Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
- Mundt M Institute of General Mechanics, RWTH Aachen, Templergraben 64, 52062 Aachen, Germany.
- Sobottke R Department of Orthopaedic and Trauma Surgery, Medizinisches Zentrum StädteRegion Aachen GmbH, Mauerfeldchen 25, 52146 Aachen, Germany; Department of Orthopaedic and Trauma Surgery, University of Cologne, Joseph-Stelzmann-Straße 9, 50924 Cologne, Germany.
- Prescher A Institute of Molecular and Cellular Anatomy, University Hospital RWTH Aachen, Wendlingweg 2, 52070 Aachen, Germany.
- Stoffel M Institute of General Mechanics, RWTH Aachen, Templergraben 64, 52062 Aachen, Germany.
- Markert B Institute of General Mechanics, RWTH Aachen, Templergraben 64, 52062 Aachen, Germany.
- Kobbe P Department for Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
- Pape HC Department of Trauma, University Hospital Zurich, Raemistr, 100, 8091 Zurich, Switzerland.
- Eysel P Department of Orthopaedic and Trauma Surgery, University of Cologne, Joseph-Stelzmann-Straße 9, 50924 Cologne, Germany.
- Siewe J Department of Orthopaedic and Trauma Surgery, University of Cologne, Joseph-Stelzmann-Straße 9, 50924 Cologne, Germany.
- 2017-03-27
Published in:
- Clinical biomechanics (Bristol, Avon). - 2017
Biomechanics
Hybrid Instrumentation
PEEK
Temperature dependency
Topping off
Aged
Aged, 80 and over
Biomechanical Phenomena
Cadaver
Decompression, Surgical
Female
Humans
Ketones
Laminectomy
Lumbar Vertebrae
Male
Middle Aged
Orthopedic Fixation Devices
Polyethylene Glycols
Range of Motion, Articular
Rotation
Spinal Fusion
Spinal Stenosis
Titanium
English
BACKGROUND
The purpose of this study was to investigate the range-of-motion after posterior polyetheretherketone-based rod stabilisation combined with a dynamic silicone hinge in order to compare it with titanium rigid stabilisation.
METHODS
Five human cadaveric lumbar spines with four vertebra each (L2 to L5) were tested in a temperature adjustable spine-testing set-up in four trials: (1) native measurement; (2) kinematics after rigid monosegmental titanium rod instrumentation with anterior intervertebral bracing of the segment L4/5; (3) kinematics after hybrid posterior polyetheretherketone rod instrumentation combined with a silicone hinge within the adjacent level (L3/4) and (4) kinematics after additional decompression with laminectomy of L4 and bilateral resection of the inferior articular processes (L3). During all steps, the specimens were loaded quasi-statically with 1°/s with pure moment up to 7.5Nm in flexion/extension, lateral bending and axial rotation.
FINDINGS
In comparison to the native cadaveric spine, both the titanium device and polyetheretherketone-based device reduce the range-of-motion within the level L4/5 significantly (flexion/extension: reduction of 77%, p<0.001; lateral bending: reduction of 62%, p<0.001; axial rotation: reduction of 71%, p<0.001). There was a clear stabilisation effect after hybrid-instrumentation within the level L3/4, especially in flexion/extension (64%, p<0.001) and lateral bending (62%, p<0.001) but without any effect on the axial rotation. Any temperature dependency has not been observed.
INTERPRETATION
Surprisingly, the hybrid device compensates for laminectomy L4 and destabilising procedure within the level L3/4 in comparison to other implants. Further studies must be performed to show its effectiveness regarding the adjacent segment instability.
The purpose of this study was to investigate the range-of-motion after posterior polyetheretherketone-based rod stabilisation combined with a dynamic silicone hinge in order to compare it with titanium rigid stabilisation.
METHODS
Five human cadaveric lumbar spines with four vertebra each (L2 to L5) were tested in a temperature adjustable spine-testing set-up in four trials: (1) native measurement; (2) kinematics after rigid monosegmental titanium rod instrumentation with anterior intervertebral bracing of the segment L4/5; (3) kinematics after hybrid posterior polyetheretherketone rod instrumentation combined with a silicone hinge within the adjacent level (L3/4) and (4) kinematics after additional decompression with laminectomy of L4 and bilateral resection of the inferior articular processes (L3). During all steps, the specimens were loaded quasi-statically with 1°/s with pure moment up to 7.5Nm in flexion/extension, lateral bending and axial rotation.
FINDINGS
In comparison to the native cadaveric spine, both the titanium device and polyetheretherketone-based device reduce the range-of-motion within the level L4/5 significantly (flexion/extension: reduction of 77%, p<0.001; lateral bending: reduction of 62%, p<0.001; axial rotation: reduction of 71%, p<0.001). There was a clear stabilisation effect after hybrid-instrumentation within the level L3/4, especially in flexion/extension (64%, p<0.001) and lateral bending (62%, p<0.001) but without any effect on the axial rotation. Any temperature dependency has not been observed.
INTERPRETATION
Surprisingly, the hybrid device compensates for laminectomy L4 and destabilising procedure within the level L3/4 in comparison to other implants. Further studies must be performed to show its effectiveness regarding the adjacent segment instability.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.clinbiomech.2017.03.009
- PMID 28342975
- Persistent URL
- https://sonar.ch/global/documents/47895
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