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Updated: May 26, 2026

Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
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Replicating interbody device subsidence with lumbar vertebraesurrogates.

A G Au1, A K Aiyangar, P A Anderson

  • 1Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA. agau@ualberta.ca

Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
|December 30, 2011
PubMed
Summary

Neither synthetic bone surrogates nor foam blocks fully replicate human cadaveric vertebrae subsidence. Both models showed limitations in accurately mimicking the material property distribution essential for precise interbody device subsidence assessment.

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Area of Science:

  • Biomaterials Science
  • Orthopedic Biomechanics
  • Spinal Surgery Research

Background:

  • Human cadaveric vertebrae are the gold standard for assessing interbody device subsidence.
  • Synthetic bone surrogates offer potential alternatives to cadaveric tissues for biomechanical testing.
  • Polyurethane foam blocks and a novel synthetic vertebra have been developed as potential surrogates.

Purpose of the Study:

  • To evaluate the ability of polyurethane foam blocks and a synthetic vertebra to replicate subsidence compared to human cadaveric vertebrae.
  • To assess the sensitivity of these surrogates to indenter placement (central vs. peripheral).
  • To determine the accuracy of current surrogates for modeling interbody device subsidence.

Main Methods:

  • Indentation testing using ring-shaped indenters on polyurethane foam blocks, a synthetic vertebra, and human cadaveric vertebrae.

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  • Comparison of qualitative characteristics and quantitative indentation metrics between surrogates and cadaveric specimens.
  • Analysis of the influence of indenter position (central vs. peripheral) on subsidence patterns.

    • Main Results:

    • Polyurethane foam blocks exhibited similar indentation characteristics to cadaveric vertebrae but lacked sensitivity to indenter placement due to homogeneous properties.
    • Cadaveric vertebrae showed significantly less peripheral indentation than central indentation due to endplate effects.
    • The synthetic vertebra demonstrated sensitivity to peripheral indentation due to its bi-material composition but had unrepresentative indentation depth and shape due to an overly strong synthetic endplate.

    Conclusions:

    • Neither polyurethane foam blocks nor the tested synthetic vertebra accurately replicate the material property distribution of human cadaveric vertebrae for subsidence modeling.
    • Current bone surrogates possess limitations in capturing the complex biomechanical response of vertebrae, particularly concerning endplate interactions.
    • Further development of bone surrogates is necessary to achieve accurate and reliable assessment of interbody device subsidence in spinal surgery research.