A critical review on the biomechanical study of cervical interbody fusion cage

Huang, Huiwen; Liu, Jinglong; Wang, Lizhen; Fan, Yubo

doi:10.1016/j.medntd.2021.100070

Cited by 22 publications

(15 citation statements)

References 112 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…32 The stiffness of the cage and the match between the cage and the endplate are the major factors need to considered because these parameters play a major role in case of adjacent level disc degeneration. 33 Biswas et al 34 reported that after implantation of single level artificial disc replacement ADR maintains the range of motion closer to natural model and it concludes a low change of disc degeneration after the implant. Rana et al 35 studied posterior dynamic stabilization with flexible rod device and found it is more effective for fusion and maintains the range of motion.…”

Section: Discussionmentioning

confidence: 92%

The biomechanical effects of S-type dynamic cage using Ti and PEEK for ACDF surgery on cervical spine varying loads

Manickam

Roy

2021

Int J Artif Organs

View full text Add to dashboard Cite

Anterior cervical discectomy with fusion (ACDF) is the common method to treat the cervical disc degeneration. The most serious problems in the fusion cages are adjacent disc degeneration, loss of lordosis, pain, subsidence, and migration of the cage. The objective of our work is to develop the three-dimensional finite element (FE) model from C3-C6 and virtually implant a designed S-type dynamic cage at C4-C5 segment of the model. The dynamic cage design will provide mobility in the early stage after ACDF surgery. Titanium (Ti) and PEEK (polyether ether ketone) were used as the material property for the cages. We applied the physiological motions at different loads from 0.5, 1, 1.5, 2.0 Nm to evaluate the dynamic cage design and the biomechanical performances of the designed S-type dynamic cage. It was observed that in all the loading condition the range of motion in the adjacent level was maintained and the maximum stress at the adjacent disc was reduced. The clinical significance of the S-type dynamic cage is better stress profile at the fusion level and adjacent segments which translates into higher rate of fusion, lower risk of cage subsidence, lower risk of adjacent segment degeneration, and good mechanical stability.

show abstract

Section: Discussionmentioning

confidence: 92%

The biomechanical effects of S-type dynamic cage using Ti and PEEK for ACDF surgery on cervical spine varying loads

Manickam

Roy

2021

Int J Artif Organs

View full text Add to dashboard Cite

show abstract

“…Moreover, by enhancing the bone graft space, the fusion rate rises and the optimized cage desirably withstands stress and subsidence. 55 As listed in Table 2, the minimum and maximum values of the tooth width and height were chosen in all three geometries. The subsidence will decrease by decreasing the tooth width and increasing its height.…”

Section: Resultsmentioning

confidence: 99%

Optimization of cervical cage and analysis of its base material: A finite element study

Jalilvand

Abolfathi

Khajehzadeh

et al. 2022

Proc Inst Mech Eng H

View full text Add to dashboard Cite

Nowadays, cervical disorders are common due to human lifestyles. Accordingly, the cage design should be optimized as an essential issue. For an optimal design, an objective function is utilized to calculate the proper geometrical parameters. Additionally, the base material of the cage plays a key role in its functionality and final cost. Novel materials are currently introduced with more compatibility with the bone in terms of mechanical and chemical properties. In this study, a cervical cage was modeled based on PEEK material with three types of tooth designs on its surface. The cervical cage is assumed to be implanted between C6 and C7 vertebrae. The geometric parameters of the cage were optimized to minimize the mass by determining allowable stress and subsidence. The effect of complete cortical removal was investigated as a surgical mistake. Finally, a new composition of PEEK/titanium was introduced as the base material of the cage. Ansys 18.2 was used for FEA. The cage with a straight tooth was chosen due to its lower stress and subsidence compared with other designs. Furthermore, the optimized structures of all three tooth designs were determined. The mass and volume of the optimal cages were reduced by 41.47% and 41.52% respectively. Besides, complete cortical resection should not be carried out during fusion surgery, since it may lead to higher subsidence. The composition of PEEK/titanium was chosen as an appropriate base material due to its better performance compared with PEEK or titanium alone.

show abstract

“… 29 Furthermore, literature indicates the importance of mechanical stability and stimulation for osseointegration. 21 , 30 , 31 Considering the differences in physiological movement of the spine when comparing ACDF to TDR, it is assumed that hybrid constructs may lead to altered biomechanical dynamics of the spine as compared to ACDF alone. 21 This altered biomechanical state may in turn influence bone regeneration and osteobiologic ingrowth.…”

Section: Discussionmentioning

confidence: 99%

The Evidence for the Use of Osteobiologics in Hybrid Constructs (Anterior Cervical Discectomy and Fusion and Total Disc Replacement) in Multilevel Cervical Degenerative Disc Disease: A Systematic Review

Hoelen,

Willems,

Loenen

et al. 2024

Global Spine Journal

View full text Add to dashboard Cite

Study Design Systematic review Objective Examine the clinical evidence for the use of osteobiologics in hybrid surgery (combined anterior cervical discectomy and fusion (ACDF) and total disc replacement (TDR)) in patients with multilevel cervical degenerative disc disease (DDD). Methods PubMed and Embase were searched between January 2000 and August 2020. Clinical studies investigating 18-80 year old patients with multilevel cervical DDD who underwent hybrid surgery with or without the use of osteobiologics were considered eligible. Two reviewers independently screened and assessed the identified articles. The methodological index for non-randomized studies (MINORS) tool and the risk of bias (RoB 2.0) assessment tool were used to assess risk of bias. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to evaluate quality of evidence across studies per outcome. Results Eleven studies were included. A decrease in cervical range of motion was observed in most studies for both the hybrid surgery and the control groups consisting of stand-alone ACDF or TDR. Fusion rates of 70-100% were reported in both the hybrid surgery and control groups consisting of stand-alone ACDF. The hybrid surgery group performed better or comparable to the control group in terms of adjacent segment degeneration. Studies reported an improvement in visual analogue scale for pain and neck disability index values after surgery compared to preoperative scores for both treatment groups. The included studies had moderate methodological quality. Conclusions There is insufficient evidence for assessing the use of osteobiologics in multilevel hybrid surgery and additional high quality and controlled research is deemed essential.

show abstract

A critical review on the biomechanical study of cervical interbody fusion cage

Cited by 22 publications

References 112 publications

The biomechanical effects of S-type dynamic cage using Ti and PEEK for ACDF surgery on cervical spine varying loads

The biomechanical effects of S-type dynamic cage using Ti and PEEK for ACDF surgery on cervical spine varying loads

Optimization of cervical cage and analysis of its base material: A finite element study

The Evidence for the Use of Osteobiologics in Hybrid Constructs (Anterior Cervical Discectomy and Fusion and Total Disc Replacement) in Multilevel Cervical Degenerative Disc Disease: A Systematic Review

Contact Info

Product

Resources

About