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In vitro evaluation of translating and rotating plates using a robot testing system under follower load.

Y Yan^1,2,3, K M Bell⁴, R A Hartman²

¹Department of Spine Surgery, The First Affiliated Hospital of University of South China, Hengyang, People's Republic of China.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

|September 1, 2015

Summary

The translating plate showed better graft load sharing than rigid and rotating plates under simulated muscle loading. This suggests improved performance for anterior cervical spine fusion procedures.

Keywords:

Anterior plate Biomechanics Cervical spine Follower load Robotics

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Area of Science:

Spinal biomechanics
Orthopedic implant technology
Surgical outcomes research

Background:

Standard rigid anterior cervical plates may not optimize load sharing with bone grafts.
Semi-constrained plates (translating or rotating) were developed to improve graft fusion.
Previous studies lacked analysis of simulated muscle loading effects on plate designs.

Purpose of the Study:

To compare the biomechanical performance of rigid, translating, and rotating anterior cervical plates.
To evaluate load sharing and graft support under simulated muscle loading conditions.
To assess the influence of plate design on cervical spine stability after corpectomy.

Main Methods:

In-vitro biomechanical testing of 15 human cervical spine specimens (C3-7).
Application of a simulated muscle load (follower load) up to 100 N.
Testing of randomized rigid, translating, and rotating plate groups under various motion conditions (flexion, extension, etc.) to a 2.0 Nm moment.

Main Results:

Translating plates maintained graft load during flexion, unlike rigid and rotating plates.
No significant difference in neutral position load sharing or C4-6 range of motion between translating and rigid plates.
Rotating plates exhibited less neutral position load sharing and failed to maintain graft load during flexion.

Conclusions:

Translating anterior cervical plates demonstrate superior load sharing compared to rigid and rotating plates under simulated muscle loading.
The findings suggest potential benefits of translating plates for improving fusion rates in anterior cervical spine surgery.
Simulated muscle loading is a critical factor in evaluating the performance of cervical spine fixation devices.