In vitro study of shear force on interbody implants

The lordosis of the lumbar spine and body weight result in significant shear forces through the lumbosacral disc spaces. These forces result in translational motion across the disc space, which is resisted but not completely abolished by pedicle screw stabilization. It is postulated that this motion may be a factor in the development of nonunion of lumbar interbody fusions. An in vitro study of the micromotion of porcine specimens implanted with serrated or smooth interbody spacers and subjected to shear forces under compressive preload was conducted to determine whether the surface serrations on vertebral interbody implants significantly resist shear forces and resulting sagittal translation.

Measurements of anterior vertebral translation were recorded on porcine cervical spine segments, subjected to 25 N of anteroposterior shear load while under a 300-N compressive preload. Baseline testing was performed on intact specimens and partially destabilized specimens (facet joints removed). Following partial discectomy, the specimens were divided into two groups for testing: one using smooth-surfaced and one using serrated interbody spacers.

Under 25-N shear load, the specimens tested with the serrated spacers showed anterior vertebral translation of 0.046 +/- 0.013 mm, whereas those tested with the smooth spacers measured 0.152 +/- 0.075 mm (P < 0.01).

The presence of surface serrations on the interbody implants significantly increased the resistance to shear forces in this model. In the clinical setting, we postulate that micromotion at interbody fusion sites will be substantially less when serrated implants are used and may help reduce the incidence of nonunion.