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Related Experiment Videos

Pullout test with three lumbar interbody fusion cages.

Rupert H J Dietl1, Matthias Krammer, Annette Kettler

  • 1Department of Neurosurgery, Bogenhausen, Academic Hospital of the Technical University of Munich, Munich, Germany. rupert.dietl@t-online.de

Spine
|May 11, 2002
PubMed
Summary

Lumbar spine interbody cages vary in pullout resistance. Cages with threads or hooks, like the Ray and Marquardt designs, offer superior stability compared to simpler designs, crucial for spinal fusion success.

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Spinal fusion research

Background:

  • Interbody cages are widely used for lumbar spine degenerative conditions.
  • Clinical use of interbody fusion cages is extensive, yet biomechanical data on pullout resistance is limited.
  • Posterior pullout trials are essential for understanding device stability.

Purpose of the Study:

  • To evaluate and compare the initial dislocation resistance of three distinct interbody cage designs.
  • To quantify pullout force as a measure of initial stability for different lumbar interbody implants.

Main Methods:

  • In vitro biomechanical testing was conducted on 12 human cadaveric lumbar spine specimens.
  • Three types of posterior interbody cages were tested: cylindrical threaded (Ray), bullet-shaped (Stryker), and rectangular titanium with endplate anchorage (Marquardt).

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  • Pullout tests were performed on four specimens for each cage type at the L3-L4 level.

    • Main Results:

    • The Ray cages exhibited the highest median pullout force (945 N), followed by Marquardt cages (605 N), and Stryker cages (130 N).
    • Significant variations in pullout force were observed among the different cage designs.
    • The Ray cages demonstrated the greatest range in pullout force (125 N to 2230 N).

    Conclusions:

    • Cage design significantly impacts the initial pullout resistance and stability in posterior lumbar interbody fusion.
    • Interbody cages incorporating threads or an endplate anchorage device provide superior stability over those with simple ridges.
    • The Ray cage design demonstrated the highest initial pullout resistance, while the Stryker cage design showed the lowest.