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In Vivo Mechanical Demands on Vertebral Body Replacements During Rehabilitation Exercises: A Multidimensional and
Maria Cesarina May1,2, Andrea Zanirato1,2, Luca Puce3
1IRCCS Azienda Ospedaliera Metropolitana, 16132 Genoa, Italy.
Bioengineering (Basel, Switzerland)
|July 28, 2026
Summary
Mechanical demands after vertebral body replacement (VBR) are task-specific, not solely posture-dependent. Loading increases over time, highlighting the need for tailored rehabilitation exercises post-VBR surgery.
Area of Science:
- Biomedical Engineering
- Orthopedic Surgery
- Biomechanics
Background:
- Mechanical complications are a concern following vertebral body replacement (VBR).
- Current exercise prescription for VBR rehabilitation often relies on simplified measures.
- Characterizing mechanical demands during VBR rehabilitation is crucial.
Purpose of the Study:
- To characterize the mechanical demands during rehabilitation exercises after VBR.
- To examine the influence of patient posture on these mechanical demands.
- To assess the effect of postoperative time on mechanical loading.
Main Methods:
- Analysis of telemetric in vivo load data from instrumented VBRs.
- Inclusion of 119 trials across 21 exercises from five patients.
- Quantification of mechanical demand using a composite SafetyIndex across six biomechanical domains.
Main Results:
- Composite SafetyIndex did not significantly differ between postures.
- Posture-specific differences were observed in peak shear ratio, peak force, and peak resultant moment.
- Postoperative time positively correlated with increased peak force, peak resultant moment, and SafetyIndex.
Conclusions:
- Mechanical demand after VBR is highly task-specific and domain-dependent.
- Posture alone is insufficient to predict mechanical loading during VBR rehabilitation.
- Rehabilitation strategies must account for increasing axial and bending loads over time.