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Inter-laboratory variability in in vitro spinal segment flexibility testing.

Daniel J Wheeler1, Andrew L Freeman, Arin M Ellingson

  • 1University of Minnesota, Minneapolis, MN, USA.

Journal of Biomechanics
|July 19, 2011
PubMed
Summary
This summary is machine-generated.

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Spine flexibility testing across four labs showed minimal range of motion (ROM) differences between facilities using pure moments. Donor variability was greater than lab variability, supporting standardized testing methods for comparable biomechanical outcomes.

Area of Science:

  • Biomechanics
  • Orthopedic Surgery
  • Spinal Research

Background:

  • In vitro spine flexibility testing methods vary significantly between laboratories, hindering result comparability.
  • Pure moments are a standard for spine flexibility testing, but differences in range of motion (ROM) due to specific loading apparatuses remain unquantified.

Purpose of the Study:

  • To quantify range of motion (ROM) differences in lumbar cadaveric spine segments tested at four independent laboratories using different pure moment application systems.
  • To determine if laboratory-specific loading apparatuses introduce significant variability in spine flexibility test results.

Main Methods:

  • Seven fresh-frozen lumbar cadaveric motion segments were tested intact at four independent laboratories.
  • Unconstrained pure moments (7.5 Nm) were applied in flexion-extension, lateral bending, and axial torsion without axial preload.

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  • Laboratories utilized varying pure moment application systems (hydraulic fixtures, cable-pulley systems) and testing protocols (sinusoidal vs. quasistatic cycles).
  • Non-contact motion measurement systems quantified range of motion (ROM).

    • Main Results:

    • Range of motion (ROM) variability among donors exceeded the variability observed between laboratories for all tested directions.
    • The maximum average ROM difference between any two laboratories was 1.5° (flexion-extension), 1.3° (lateral bending), and 1.1° (axial torsion).
    • This study is the first to compare ROM across multiple laboratories using diverse pure moment systems on the same set of spinal motion segments.

    Conclusions:

    • Independent laboratories can achieve similar biomechanical outcomes in spine flexibility testing when using a well-described methodology.
    • Donor variability is a more significant factor in in vitro spine flexibility testing than the specific pure moment application system used.
    • Standardization of in vitro spine testing protocols can enhance the reliability and comparability of biomechanical data across research institutions.