Biomechanical analysis of cages for posterior lumbar interbody fusion

Alfonso Fantigrossi, Fabio Galbusera, Manuela Teresa Raimondi, Marco Sassi, Maurizio Fornari

Research output: Contribution to journalArticlepeer-review

Abstract

Interbody fusions using intervertebral cages have become increasingly common in spinal surgery. Computational simulations were conducted in order to compare different cage designs in terms of their biomechanical interaction with the spinal structures. Differences in cage design and surgical technique may significantly affect the biomechanics of the fused spine segment, but little knowledge is available on this topic. In the present study, four 3D finite element models were developed, reproducing the human L4-L5 spinal unit in intact condition and after implantation of three different cage models. The intact model consisted of two vertebral bodies and relevant laminae, facet joints, main ligaments and disc. The instrumented models reproduced the post-operative conditions resulting after implant of the different cages. The three considered devices were hollow threaded titanium cages, the BAK™ (Zimmer Centerpulse, Warsaw, IN, USA), the Interfix™ and the Interfix Fly™ (both by Medtronic Sofamor Danek, Memphis, TN, USA). Simulations were run imposing various loading conditions, under a constant compressive preload. A great increase in the stiffness induced on the spinal segment by all cages was observed in all the considered loading cases. Stress distributions on the bony surface were evaluated and discussed. The differences observed between the biomechanics of the instrumented models were associated with the geometrical and surgical features of the devices.

Original languageEnglish
Pages (from-to)101-109
Number of pages9
JournalMedical Engineering and Physics
Volume29
Issue number1
DOIs
Publication statusPublished - Jan 2007

Keywords

  • Biomechanics
  • Cage
  • Finite element model
  • Interbody fusion
  • Lumbar

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Psychology(all)

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