Related Experiment Video
Updated: Aug 25, 2025
Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
Published on: July 25, 2025
Biomechanical Comparison of Subsidence Between Patient-Specific and Non-Patient-Specific Lumbar Interbody Fusion
Renan J R Fernandes1,2,3, Aaron Gee1,3, Andrew J Kanawati4
1Combined Orthopaedic and Neurosurgery Spine Program, London Health Science Centre, London, ON, Canada.
Study Design:
Biomechanical study.
Objectives:
Several strategies to improve the surface of contact between an interbody device and the endplate have been employed to attenuate the risk of cage subsidence. 3D-printed patient-specific cages have been presented as a promising alternative to help mitigate that risk, but there is a lack of biomechanical evidence supporting their use. We aim to evaluate the biomechanical performance of 3D printed patient-specific lumbar interbody fusion cages in relation to commercial cages in preventing subsidence.
Methods:
A cadaveric model is used to investigate the possible advantage of 3D printed patient-specific cages matching the endplate contour using CT-scan imaging in preventing subsidence in relation to commercially available cages (Medtronic Fuse and Capstone). Peak failure force and stiffness were analyzed outcomes for both comparison groups.
Results:
PS cages resulted in significantly higher construct stiffness when compared to both commercial cages tested (>59%). PS cage peak failure force was 64% higher when compared to Fuse cage (P < .001) and 18% higher when compared to Capstone cage (P = .086).
Conclusions:
Patient-specific cages required higher compression forces to produce failure and increased the cage-endplate construct' stiffness, decreasing subsidence risk.
