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Published on: October 10, 2025
Reducing subsidence risk by using rapid manufactured patient-specific intervertebral disc implants
Neal de Beer1, Cornie Scheffer
1Department of Industrial Engineering, Stellenbosch University, Private Bag X1, Matieland 7602, South Africa. ndebeer@sun.ac.za
Summary
Customized intervertebral disc implants with matching bone geometry significantly improve load distribution and stiffness compared to flat implants. This enhanced biomechanical performance may reduce the risk of implant subsidence and vertebral fracture.
Area of Science:
- Biomechanical engineering
- Spinal implant technology
- Orthopedic research
Background:
- Intervertebral disc implant design (size, shape, position) impacts subsidence and fracture risk.
- Rapid manufacturing enables patient-specific implants in various fields, but its spinal application is underexplored.
Purpose of the Study:
- To investigate enhanced load distribution and stiffness using implants with bone-matching interface geometry versus flat end plates.
- To evaluate the biomechanical benefits of customized spinal implant designs.
Main Methods:
- Biomechanical investigation comparing compressive loads on cadaveric vertebrae with two implant end plate designs (conformal vs. flat).
- Utilized 88 vertebrae (C3-L5) from four male cadavers; 20 vertebrae (C3-L3) underwent testing after eligibility screening.
- Assessed load distribution and surface contact using pressure sensors during nondestructive tests and failure loads/stiffness during destructive tests.
Main Results:
- Conformal implants demonstrated significantly higher average surface contact area (45.27%) compared to flat implants (10.49%, p<.001).
- Conformal implants achieved higher failure loads and significantly greater stiffness (p<.0001) in destructive compression tests.
- Cervical vertebrae showed particularly higher contact due to pronounced end plate concavity.
Conclusions:
- Customizing intervertebral disc implant end plate geometry offers potential benefits, including reduced subsidence risk.
- The study showed a 137% increase in stiffness with conformal implants, highlighting significant advantages of customization in implant design and manufacture.
