[Effect of various cylinder diameters of implants for lumbar inter-corporeal spinal fusion on compressive strength on...

Anterior lumbar interbody fusion (ALIF) has evolved as a minimally invasive technique for treating lumbar instability caused by degenerative lumbar disc disease. A practical surgical method is the lateral retroperitoneal approach in which cylindrical implants are inserted in the intervertebral space. The optimal diameter of these implants remains unclear. The purpose of this biomechanical study was to investigate the influence of implant diameter on selected mechanical properties of the functional spinal units (FSU). In fresh frozen bovine FSU the bone density was first determined and cylindrical implants were then inserted. The FSU were then tested under compression loading in a material-testing machine. A tendency of the "failure loads" to decrease with increasing cylinder diameter was observed. The study reveals a strong correlation between bone density and loading capacity, with higher loads being sustained by the more strongly mineralized bone. In contrast to homogeneous material, in an FSU, larger cylinder diameter does not result in an increase in compression strength.