Evaluation of the contact surface between vertebral endplate and 3D printed patient-specific cage vs commercial cage

Fernandes, Renan; Gee, Aaron; Kanawati, Andrew; Siddiqi, Fawaz; Rasoulinejad, Parham; Zdero, Radovan; Bailey, Christopher S.

doi:10.1038/s41598-022-16895-9

Cited by 8 publications

(7 citation statements)

References 18 publications

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“…So it can help reduce the contact stress. [ 29 ] Wu et al [ 30 ] proved that the fusion cage with larger axial area can reduce the stress of the internal fixation system and the stress at the interface between the fusion cage and the end plate through finite element analysis. It plays a certain role in preventing the sinking of the fusion cage and the failure of the internal fixation system.…”

Section: Discussionmentioning

confidence: 99%

The postoperative clinical effects of utilizing 3D printed (Ti6Al4V) interbody fusion cages in posterior lumbar fusion: A retrospective cohort study

Wang,

Zhang,

Zhang

et al. 2024

Medicine

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Background: The research focused on the postoperative effect of using interbody fusion cage in lumbar posterior lamina decompression and interbody fusion with pedicle screw by comparing the postoperative effect of using 3D printing (Ti6Al4V) and PEEK material interbody fusion cage. Methods: Ninety-one patients with lumbar degenerative diseases from the Department of Spine Surgery of Tianjin Hospital were included in the study cohort. They were divided into 3D group (n = 39) and PEEK group (n = 52) according to the use of interbody fusion cage. The imaging data of the patients were collected and the postoperative data of the 2 groups were compared to evaluate patients’ health status and the recovery of lumbar structure and function after operation. Results: Combined with the degree of fusion, the clinical effect of 3D printing titanium alloy interbody fusion cage was comprehensively judged. At the last follow-up, the JOA score, ODI index, VAS, prolo function score, and SF-36 scale of the 2 groups showed that the clinical symptoms were better than those before operation (P < .05). The height of intervertebral disc, the area of intervertebral foramen and the physiological curvature of lumbar vertebrae increased in varying degrees after operation (P < .05). At the last follow-up, the vertebral cage fusion rates were as high as 89.13% and 90.91% in the 3D and PEEK groups, with collapse rates of 6.5% and 4.5%, respectively. There were 10 cases of cage displacement in 3D group and 7 cases of cage displacement in PEEK group. There was no significant difference between the 2 groups (P > .05). Conclusions: In conclusion, 3D printed (Ti6Al4V) interbody fusion cage can obtain good clinical effect in the surgical treatment of lumbar degenerative diseases. Posterior lumbar lamina decompression, bilateral pedicle screw fixation combined with 3D printed cage interbody fusion is excellent in rebuilding the stability of lumbar vertebrae. 3D printed interbody fusion cage can be an ideal substitute material for intervertebral bone grafting. The stable fusion time of interbody fusion cage after lumbar fusion is mostly from 3 months to half a year after operation.

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Section: Discussionmentioning

confidence: 99%

The postoperative clinical effects of utilizing 3D printed (Ti6Al4V) interbody fusion cages in posterior lumbar fusion: A retrospective cohort study

Wang,

Zhang,

Zhang

et al. 2024

Medicine

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“…The imaging modalities' limitations include a loss of accuracy in regard to the microanatomy of the endplate but still delivering better results than the commercial cages. 22 Another factor influencing subsidence risks is the mismatch between the endplate elastic modulus and the cages' material elastic modulus. 24 Due to the higher elastic modulus, titanium cages are more prone to subside than PEEK cages.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Comparison of Subsidence Between Patient-Specific and Non-Patient-Specific Lumbar Interbody Fusion Cages

Fernandes

Gee

Kanawati

et al. 2022

Global Spine Journal

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Study Design Biomechanical study. Objectives Several strategies to improve the surface of contact between an interbody device and the endplate have been employed to attenuate the risk of cage subsidence. 3D-printed patient-specific cages have been presented as a promising alternative to help mitigate that risk, but there is a lack of biomechanical evidence supporting their use. We aim to evaluate the biomechanical performance of 3D printed patient-specific lumbar interbody fusion cages in relation to commercial cages in preventing subsidence. Methods A cadaveric model is used to investigate the possible advantage of 3D printed patient-specific cages matching the endplate contour using CT-scan imaging in preventing subsidence in relation to commercially available cages (Medtronic Fuse and Capstone). Peak failure force and stiffness were analyzed outcomes for both comparison groups. Results PS cages resulted in significantly higher construct stiffness when compared to both commercial cages tested (>59%). PS cage peak failure force was 64% higher when compared to Fuse cage ( P < .001) and 18% higher when compared to Capstone cage ( P = .086). Conclusions Patient-specific cages required higher compression forces to produce failure and increased the cage-endplate construct' stiffness, decreasing subsidence risk.

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“…Akin to neurosegmentation, descriptions of patient-specific interbody cages are emerging in the literature; however, at the time of writing, such 3D-printed interbody reports are limited to small case studies and complex applications [67][68][69][70][71]. Early cadaveric feasibility studies have demonstrated that patient-specific cages increase contact area and decrease contact stress more so than their 'off-the-shelf' counterparts [72]. Although these early reports are promising, a large-scale prospective study is certainly required before such custom cages can become commonplace.…”

Section: Patient-specific Implantsmentioning

confidence: 99%

Evolution of the Transforaminal Lumbar Interbody Fusion (TLIF): From Open to Percutaneous to Patient-Specific

Drossopoulos,

Ononogbu-uche,

Tabarestani

et al. 2024

JCM

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The transforaminal lumbar interbody fusion (TLIF) has seen significant evolution since its early inception, reflecting advancements in surgical techniques, patient safety, and outcomes. Originally described as an improvement over the posterior lumbar interbody fusion (PLIF), the TLIF began as an open surgical procedure, that notably reduced the need for the extensive neural retractation that hindered the PLIF. In line with the broader practice of surgery, trending toward minimally invasive access, the TLIF was followed by the development of the minimally invasive TLIF (MIS-TLIF), a technique that further decreased tissue trauma and postoperative complications. Subsequent advancements, including Trans-Kambin’s Triangle TLIF (percLIF) and transfacet LIF, have continued to refine surgical access, minimize surgical footprint, and reduce the risk of injury to the patient. The latest evolution, as we will describe it, the patient-specific TLIF, is a culmination of the aforementioned adaptations and incorporates advanced imaging and segmentation technologies into perioperative planning, allowing surgeons to tailor approaches based on individual patient anatomy and pathology. These developments signify a shift towards more precise methods in spine surgery. The ongoing evolution of the TLIF technique illustrates the dynamic nature of surgery and emphasizes the need for continued adaptation and refinement.

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Evaluation of the contact surface between vertebral endplate and 3D printed patient-specific cage vs commercial cage

Cited by 8 publications

References 18 publications

The postoperative clinical effects of utilizing 3D printed (Ti6Al4V) interbody fusion cages in posterior lumbar fusion: A retrospective cohort study

The postoperative clinical effects of utilizing 3D printed (Ti6Al4V) interbody fusion cages in posterior lumbar fusion: A retrospective cohort study

Biomechanical Comparison of Subsidence Between Patient-Specific and Non-Patient-Specific Lumbar Interbody Fusion Cages

Evolution of the Transforaminal Lumbar Interbody Fusion (TLIF): From Open to Percutaneous to Patient-Specific

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