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Neurosurgery:
doi: 10.1227/01.NEU.0000370200.74098.CC
INSTRUMENTATION: SPINE: Instrumentation Assessment

Comparison of Allograft Bone and Titanium Cages for Vertebral Body Replacement in the Thoracolumbar Spine: A Biomechanical Study

Cardenas, Raul J. MD; Javalkar, Vijayakumar MD; Patil, Shashikant MD; Gonzalez-Cruz, Jorge MD; Ogden, Alan BSME; Mukherjee, Debi PhD; Nanda, Anil MD, FACS

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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°), 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.

Copyright © by the Congress of Neurological Surgeons

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