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Published in: European Spine Journal 5/2012

01-06-2012 | Original Article

An in vitro biomechanical comparison of Cadisc™-L with natural lumbar discs in axial compression and sagittal flexion

Authors: Donal McNally, Jason Naylor, Scott Johnson

Published in: European Spine Journal | Special Issue 5/2012

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Abstract

Introduction

The elastomeric, monobloc disc prosthesis (Cadisc™-L, Ranier Technology, Cambridge, UK) aims to preserve biomechanics of an implanted spinal motion segment.

Study design

This study presents the findings of an in vitro investigation on the effect of implantation of Cadisc™-L. Compressive stiffness, flexion stiffness at 10, 20, 30 and 40 Nm and the instant-axis-of-rotation (IAR) loci are compared before and after implantation of a MC-10 mm-6° Cadisc™-L.

Methods

Fresh frozen human monosegmental lumbar spines (n = 8) were prepared, potted and tested in an environmentally controlled chamber to simulate in vivo conditions. Specimens were preconditioned by loading to 500 N for 30 min. Compressive stiffness of the specimen was determined by applying pure compression of 1 kN at 250 N/s via a loading roller positioned at the central loading axis (CLA). The roller was then offset 12.5 mm anterior of the CLA and the loading regime repeated to test specimens in flexion. Bending moments were calculated from the applied load and corresponding flexion angle. The IAR locus was tracked by a motion-tracking camera.

Results

Compressive stiffness was reduced by 50 % (p = 0.0005), flexion stiffness was not statistically significantly reduced (40 % reduction, p > 0.05). IAR locus maintained a ‘horizontal figure of eight’ characteristic. Change in the locus width in the AP plane of 6.4 mm (p = 0.06) and height in the SI plane of 1.3 mm (p = 0.44) were not significant. The centroid was displaced 4.44 mm (p = 0.0019) and 5.44 mm (p = 0.025) at 3° and 6° flexion, respectively.

Conclusions

Implantation of Cadisc™-L caused a reduction in axial stiffness, but maintained disc height and flexion stiffness. IAR loci remained mobile without large displacement of the centroid from the intact spine position.
Literature
1.
go back to reference Waris E et al (2007) Disc degeneration in low back pain: a 17-year follow-up study using magnetic resonance imaging. Spine 32(6):681–684PubMedCrossRef Waris E et al (2007) Disc degeneration in low back pain: a 17-year follow-up study using magnetic resonance imaging. Spine 32(6):681–684PubMedCrossRef
2.
go back to reference Tanaka N et al (2001) The relationship between disc degeneration and flexibility of the lumbar spine. Spine J 1(1):47–56PubMedCrossRef Tanaka N et al (2001) The relationship between disc degeneration and flexibility of the lumbar spine. Spine J 1(1):47–56PubMedCrossRef
3.
go back to reference Burton AK et al (1996) Lumbar disc degeneration and sagittal flexibility. J Spinal Disord 9(5):418–424PubMedCrossRef Burton AK et al (1996) Lumbar disc degeneration and sagittal flexibility. J Spinal Disord 9(5):418–424PubMedCrossRef
4.
go back to reference Mimura M et al (1994) Disc degeneration affects the multidirectional flexibility of the lumbar spine. Spine 19(12):1371–1380PubMedCrossRef Mimura M et al (1994) Disc degeneration affects the multidirectional flexibility of the lumbar spine. Spine 19(12):1371–1380PubMedCrossRef
5.
go back to reference van Ooij A et al (2007) Polyethylene wear debris and long-term clinical failure of the Charite disc prosthesis: a study of 4 patients. Spine (Phila Pa 1976) 32(2):223–229CrossRef van Ooij A et al (2007) Polyethylene wear debris and long-term clinical failure of the Charite disc prosthesis: a study of 4 patients. Spine (Phila Pa 1976) 32(2):223–229CrossRef
6.
go back to reference Kurtz SM et al (2007) Polyethylene wear and rim fracture in total disc arthroplasty. Spine J 7(1):12–21PubMedCrossRef Kurtz SM et al (2007) Polyethylene wear and rim fracture in total disc arthroplasty. Spine J 7(1):12–21PubMedCrossRef
8.
go back to reference Gwynne JH, Oyen ML, Cameron RE (2010) Preparation of polymeric samples containing a graduated modulus region and development of nanoindentation linescan techniques. Polym Testing 29(4):494–502CrossRef Gwynne JH, Oyen ML, Cameron RE (2010) Preparation of polymeric samples containing a graduated modulus region and development of nanoindentation linescan techniques. Polym Testing 29(4):494–502CrossRef
9.
go back to reference Adams MA, Dolan P (1991) A technique for quantifying the bending moment acting on the lumbar spine in vivo. J Biomech 24(2):117–126PubMedCrossRef Adams MA, Dolan P (1991) A technique for quantifying the bending moment acting on the lumbar spine in vivo. J Biomech 24(2):117–126PubMedCrossRef
10.
go back to reference Thompson JP et al (1990) Preliminary evaluation of a scheme for grading the gross morphology of the human intervertebral disc. Spine (Phila Pa 1976) 15(5):411–415CrossRef Thompson JP et al (1990) Preliminary evaluation of a scheme for grading the gross morphology of the human intervertebral disc. Spine (Phila Pa 1976) 15(5):411–415CrossRef
11.
go back to reference de Visser H, Rowe C, Pearcy M (2007) A robotic testing facility for the measurement of the mechanics of spinal joints. Proc Inst Mech Eng [H] 221(3):221–227CrossRef de Visser H, Rowe C, Pearcy M (2007) A robotic testing facility for the measurement of the mechanics of spinal joints. Proc Inst Mech Eng [H] 221(3):221–227CrossRef
12.
go back to reference Adams MA (1995) Mechanical testing of the spine. An appraisal of methodology, results, and conclusions. Spine (Phila Pa 1976) 20(19):2151–2156CrossRef Adams MA (1995) Mechanical testing of the spine. An appraisal of methodology, results, and conclusions. Spine (Phila Pa 1976) 20(19):2151–2156CrossRef
13.
go back to reference Oxland TR et al (1992) The effect of injury on rotational coupling at the lumbosacral joint. A biomechanical investigation. Spine (Phila Pa 1976) 17(1):74–80CrossRef Oxland TR et al (1992) The effect of injury on rotational coupling at the lumbosacral joint. A biomechanical investigation. Spine (Phila Pa 1976) 17(1):74–80CrossRef
14.
go back to reference Reuleaux F (1876) Kinematics of Machinery. MacMillan and Co, New York Reuleaux F (1876) Kinematics of Machinery. MacMillan and Co, New York
15.
go back to reference Hansson T, Roos B, Nachemson A (1980) The bone mineral content and ultimate compressive strength of lumbar vertebrae. Spine (Phila Pa 1976) 5(1):46–55CrossRef Hansson T, Roos B, Nachemson A (1980) The bone mineral content and ultimate compressive strength of lumbar vertebrae. Spine (Phila Pa 1976) 5(1):46–55CrossRef
16.
go back to reference Heuer F et al (2007) Stepwise reduction of functional spinal structures increase range of motion and change lordosis angle. J Biomech 40(2):271–280PubMedCrossRef Heuer F et al (2007) Stepwise reduction of functional spinal structures increase range of motion and change lordosis angle. J Biomech 40(2):271–280PubMedCrossRef
17.
go back to reference Hitchon PW et al (2005) Biomechanical studies of an artificial disc implant in the human cadaveric spine. J Neurosurg Spine 2(3):339–343PubMedCrossRef Hitchon PW et al (2005) Biomechanical studies of an artificial disc implant in the human cadaveric spine. J Neurosurg Spine 2(3):339–343PubMedCrossRef
18.
go back to reference Kotani Y et al (2006) Multidirectional flexibility analysis of anterior and posterior lumbar artificial disc reconstruction: in vitro human cadaveric spine model. Eur Spine J 15(10):1511–1520PubMedCrossRef Kotani Y et al (2006) Multidirectional flexibility analysis of anterior and posterior lumbar artificial disc reconstruction: in vitro human cadaveric spine model. Eur Spine J 15(10):1511–1520PubMedCrossRef
19.
go back to reference Rousseau MA et al (2006) Disc arthroplasty design influences intervertebral kinematics and facet forces. Spine J 6(3):258–266PubMedCrossRef Rousseau MA et al (2006) Disc arthroplasty design influences intervertebral kinematics and facet forces. Spine J 6(3):258–266PubMedCrossRef
20.
go back to reference Gertzbein SD et al (1985) Centrode patterns and segmental instability in degenerative disc disease. Spine (Phila Pa 1976) 10(3):257–261CrossRef Gertzbein SD et al (1985) Centrode patterns and segmental instability in degenerative disc disease. Spine (Phila Pa 1976) 10(3):257–261CrossRef
21.
go back to reference Gertzbein SD et al (1986) Centrode characteristics of the lumbar spine as a function of segmental instability. Clin Orthop Relat Res 208:48–51PubMed Gertzbein SD et al (1986) Centrode characteristics of the lumbar spine as a function of segmental instability. Clin Orthop Relat Res 208:48–51PubMed
22.
go back to reference Pearcy MJ, Bogduk N (1988) Instantaneous axes of rotation of the lumbar intervertebral joints. Spine (Phila Pa 1976) 13(9):1033–1041CrossRef Pearcy MJ, Bogduk N (1988) Instantaneous axes of rotation of the lumbar intervertebral joints. Spine (Phila Pa 1976) 13(9):1033–1041CrossRef
23.
go back to reference Seligman JV et al (1984) Computer analysis of spinal segment motion in degenerative disc disease with and without axial loading. Spine (Phila Pa 1976) 9(6):566–573CrossRef Seligman JV et al (1984) Computer analysis of spinal segment motion in degenerative disc disease with and without axial loading. Spine (Phila Pa 1976) 9(6):566–573CrossRef
24.
go back to reference Ogston NG et al (1986) Centrode patterns in the lumbar spine. Baseline studies in normal subjects. Spine (Phila Pa 1976) 11(6):591–595CrossRef Ogston NG et al (1986) Centrode patterns in the lumbar spine. Baseline studies in normal subjects. Spine (Phila Pa 1976) 11(6):591–595CrossRef
Metadata
Title
An in vitro biomechanical comparison of Cadisc™-L with natural lumbar discs in axial compression and sagittal flexion
Authors
Donal McNally
Jason Naylor
Scott Johnson
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue Special Issue 5/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2249-4

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