Biomechanical Evaluation of a Novel S-Type, Dynamic Zero-Profile Cage Design for Anterior Cervical Discectomy and Fusion with Variations in Bone Graft Shape: A Finite Element Analysis

Manickam, P.; Roy, Sandipan; Shetty, Gautam M.

doi:10.1016/j.wneu.2021.07.013

Cited by 26 publications

(18 citation statements)

References 58 publications

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“…The stress stimulation of the bone graft implanted in the cage critically affects postoperative bone healing. Appropriate stress stimulation of the bone graft accelerates bone growth and better bridges the postoperative segmental fusion [ 30 ]. Fig.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical analysis of customized cage conforming to the endplate morphology in anterior cervical discectomy fusion: A finite element analysis

Sun

Han

Sui

et al. 2023

Heliyon

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Section: Discussionmentioning

confidence: 99%

Biomechanical analysis of customized cage conforming to the endplate morphology in anterior cervical discectomy fusion: A finite element analysis

Sun

Han

Sui

et al. 2023

Heliyon

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“…In the present study, the patient demographic data (age, sex, operative time, blood loss, and segments) of Groups A and B were similar, while the primary difference between the two groups was cage shape. Different cage shapes correlated with different cage-endplate interfaces and bone graft shapes and volumes and finally led to variational postoperative fusion and subsidence resistance [ 14 , 22 ]. Compared to the hollow cylindrical n-HA/PA66 cage, the novel n-HA/PA66 cage’s horseshoe shape has more inverse distributed jags, which can better mimic the concave contour of the vertebral endplate and improve the contact area and anchorage.…”

Section: Discussionmentioning

confidence: 99%

A novel nanohydroxyapatite/polyamide-66 cage for reducing the subsidence rate after single-level anterior cervical discectomy and fusion: a comparative study of 7-year follow-up

et al. 2023

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Background A novel nanohydroxyapatite/polyamide-66 cage (n-HA/PA66 cage) with a horseshoe shape was designed to lower the subsidence rate of the traditional hollow cylindrical n-HA/PA66 cage. However, no studies have compared the incidence of subsidence in the two cages. The purpose of this study was to compare the long-term clinical and radiological outcomes of the novel n-HA/PA66 cage with the hollow cylindrical n-HA/PA66 cage after anterior cervical discectomy and fusion (ACDF) to treat single-level cervical degenerative disk disease (CDDD). Methods Fifty-two patients with novel n-HA/PA66 cages (Group A) and fifty-five patients with hollow cylindrical n-HA/PA66 cages (Group B) were included. The radiological parameters included intervertebral height (IH), C2-7 angle (C2-7a), segmental alignment (SA), subsidence rate, and fusion rate. The clinical outcomes were visual analog scale (VAS) scores, Japanese Orthopedic Association (JOA) scores, and patient satisfaction rates. Results The pre- and postoperative SA, C2-7a, and fusion rates of the patients in Groups A and B were similar. The preoperative and 6-month postoperative IHs in both groups were comparable. However, the final follow-up IH in Group B was significantly smaller than that in Group A (35.9 mm vs. 36.7 mm). The difference in the subsidence rates at the final follow-up between Group A (5.8%, 3/52) and Group B (18.2%, 10/55) was significant. The VAS score, JOA score, and patient satisfaction rate were not significantly different. Conclusions The novel n-HA/PA66 cage had similar favorable SA, C2-7a, fusion rate, and clinical outcomes compared to the hollow cylindrical n-HA/PA66 cage for treating single-level ACDF. Moreover, the novel n-HA/PA66 cage achieved a lower subsidence rate and higher IH than the hollow cylindrical n-HA/PA66 cage at the final follow-up.

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“…These findings may help us understand why patients using zero-profile devices have a lower incidence of adjacent segment degeneration (ASD) complications than patients using PCC. A novel S-Type dynamic zero-profile cervical cage was designed and evaluated by combining the characteristics of the dynamic cage and the zero-profile system (as shown in Figure 4B ) ( Manickam et al, 2021 ). In terms of segmental ROM changes and stress levels, this cage produced positive results.…”

Section: Fea Advances In Icsmentioning

confidence: 99%

“… (A) Z-Brace dynamic fusion cage, adapted with permission from ( Liu et al, 2017a ). Copyright 2017, SAGE, and (B) S-Type dynamic zero-profile cervical cage, adapted with permission from ( Manickam et al, 2021 ). Copyright 2021, Elsevier.…”

Section: Fea Advances In Icsmentioning

confidence: 99%

Recent advancement in finite element analysis of spinal interbody cages: A review

Wang

2023

Front. Bioeng. Biotechnol.

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Finite element analysis (FEA) is a widely used tool in a variety of industries and research endeavors. With its application to spine biomechanics, FEA has contributed to a better understanding of the spine, its components, and its behavior in physiological and pathological conditions, as well as assisting in the design and application of spinal instrumentation, particularly spinal interbody cages (ICs). IC is a highly effective instrumentation for achieving spinal fusion that has been used to treat a variety of spinal disorders, including degenerative disc disease, trauma, tumor reconstruction, and scoliosis. The application of FEA lets new designs be thoroughly “tested” before a cage is even manufactured, allowing bio-mechanical responses and spinal fusion processes that cannot easily be experimented upon in vivo to be examined and “diagnosis” to be performed, which is an important addition to clinical and in vitro experimental studies. This paper reviews the recent progress of FEA in spinal ICs over the last six years. It demonstrates how modeling can aid in evaluating the biomechanical response of cage materials, cage design, and fixation devices, understanding bone formation mechanisms, comparing the benefits of various fusion techniques, and investigating the impact of pathological structures. It also summarizes the various limitations brought about by modeling simplification and looks forward to the significant advancement of spine FEA research as computing efficiency and software capabilities increase. In conclusion, in such a fast-paced field, the FEA is critical for spinal IC studies. It helps in quantitatively and visually demonstrating the cage characteristics after implanting, lowering surgeons’ learning costs for new cage products, and probably assisting them in determining the best IC for patients.

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Biomechanical Evaluation of a Novel S-Type, Dynamic Zero-Profile Cage Design for Anterior Cervical Discectomy and Fusion with Variations in Bone Graft Shape: A Finite Element Analysis

Cited by 26 publications

References 58 publications

Biomechanical analysis of customized cage conforming to the endplate morphology in anterior cervical discectomy fusion: A finite element analysis

Biomechanical analysis of customized cage conforming to the endplate morphology in anterior cervical discectomy fusion: A finite element analysis

A novel nanohydroxyapatite/polyamide-66 cage for reducing the subsidence rate after single-level anterior cervical discectomy and fusion: a comparative study of 7-year follow-up

Recent advancement in finite element analysis of spinal interbody cages: A review

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