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Augmentation improves human cadaveric vertebral body compression mechanics for lumbar total disc replacement
Jonathon H Yoder1, Joshua D Auerbach, Philip M Maurer
1Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA.
Spine
|April 9, 2010
Summary
Vertebral augmentation significantly improved the mechanical properties of lumbar vertebrae under axial compression from total disc replacement (TDR) implants, enhancing subfailure stress and modulus.
Area of Science:
- Spine biomechanics
- Biomaterials in orthopedics
- Degenerative disc disease treatment
Background:
- Total disc replacement (TDR) is an alternative to lumbar spinal fusion for degenerative disc disease.
- Osteoporosis in adjacent vertebrae can lead to TDR implant subsidence or fracture.
- Vertebral augmentation is used for osteoporotic compression fractures.
Purpose of the Study:
- To quantify the effects of vertebral body augmentation on lumbar spine biomechanics.
- To evaluate if augmentation improves mechanical properties under axial compression by a TDR implant.
Main Methods:
- Cadaveric biomechanical study using 45 lumbar vertebral segments (L1-L5).
- Bone density determined by peripheral quantitative computed tomography (pQCT).
- Specimens randomized into augmentation (Cortoss fill) and control groups; TDR implantation followed by axial compression testing.
Main Results:
- Augmentation significantly increased subfailure mechanical properties (2x higher than control).
- Maximum apparent stress and modulus were 2x and 1.3x greater in the augmented group, respectively.
- Augmented subfailure stress and apparent modulus showed moderate correlation with bone density.
Conclusions:
- Vertebral augmentation enhances the mechanical properties of the lumbar vertebral body.
- Augmentation improves resistance to compression forces from TDR implants.
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