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  • Title: Comparison of allograft bone and titanium cages for vertebral body replacement in the thoracolumbar spine: a biomechanical study.
    Author: Cardenas RJ, Javalkar V, Patil S, Gonzalez-Cruz J, Ogden A, Mukherjee D, Nanda A.
    Journal: Neurosurgery; 2010 Jun; 66(6 Suppl Operative):314-8; discussion 318. PubMed ID: 20489522.
    Abstract:
    BACKGROUND: When an anterior approach to repair a burst fracture is indicated, several devices can be used to restore spinal stability (eg, bone graft, free-standing titanium cage, and expandable titanium cage). OBJECTIVE: We compare the biomechanical stability and prices of each of these systems. MATERIALS AND METHODS: Eight fresh human cadaver T11 through L3 vertebral specimens were harvested and cleaned of soft tissues. T11-T12 and L2-L3 were fixed by screws. The fixed ends were then set in automotive body filler (Bondo). The prepared specimens were tested in the Biaxial Instron tester (8874, Norwood, MA) after a sequence of the following: intact, after the creation of an anterior corpectomy at L1, and after insertion of both of the 2 different titanium cages and the fibular graft. A titanium screw-and-plate anterolateral system was used to secure the construct (VANTAGE, Medtronic Sofamor Danek, Memphis, TN). The conditions of displacement testing were as follows: rotation (+/- 3.5 degrees ), flexion and extension, and left and right bending (+/- 3.5 mm). For each mode of testing, the stiffness was calculated. RESULTS: The stiffness data, when statistically analyzed by repeated-measures analysis of variance (at P = .05 and power > 0.9), indicated no significant differences among these devices. CONCLUSION: On the basis of this biomechanical study, the stiffness of the fibular graft was similar to that of the other metallic devices in this cadaver model.
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