[Artificial Disc Replacement] Local & global subaxial cervical spine biomechanics after single-level fusion or cervical arthroplasty

[Justin]

European Spine Journal
Volume 18, Number 10 / October, 2009 / Pages 1520-1527

Local and global subaxial cervical spine biomechanics after single-level fusion or cervical arthroplasty

Michael A. Finn1, Darrel S. Brodke2 , Michael Daubs2, Alpesh Patel2 and Kent N. Bachus3
(1) Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, UT, USA (2) Department of Orthopedic Surgery, University Orthopaedic Center, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA (3) Orthopaedic Bioengineering Laboratory, University of Utah School of Medicine, Salt Lake City, UT, USA
© 2009, Springer-Verlag

An experimental in vitro biomechanical study was conducted on human cadaveric spines to evaluate the motion segment (C4–C5) and global subaxial cervical spine motion after placement of a cervical arthroplasty device (Altia TDI™, Amedica, Salt Lake City, UT) as compared to both the intact spine and a single-level fusion. Six specimens (C2–C7) were tested in flexion/extension, lateral bending, and axial rotation under a ± 1.5 Nm moment with a 100 N axial follower load. Following the intact spine was tested; the cervical arthroplasty device was implanted at C4–C5 and tested. Then, a fusion using lateral mass fixation and an anterior plate was simulated and tested. Stiffness and range of motion (ROM) data were calculated. The ROM of the C4–C5 motion segment with the arthroplasty device was similar to that of the intact spine in flexion/extension and slightly less in lateral bending and rotation, while the fusion construct allowed significantly less motion in all directions. The fusion construct caused broader effects of increasing motion in the remaining segments of the subaxial cervical spine, whereas the TDI did not alter the adjacent and remote motion segments. The fusion construct was also far stiffer in all motion planes than the intact motion segment and the TDI, while the artificial disc treated level was slightly stiffer than the intact segment. The Altia TDI allows for a magnitude of motion similar to that of the intact spine at the treated and adjacent levels in the in vitro setting.

Cervical arthroplasty - Biomechanics - Subaxial spine - Fusion

[Justin]

Note: the Altia TDI™ (total disc implant), mentioned in the abstract above, is a new Artificial Disc Replacement device.

Here's some background information on the Altia TDI™ from the full-text publication:

The device is composed of a silicon-nitride ceramic with superior wear characteristics than existing metal and polymer designs, while allowing for imaging the clarity of nearby structures with magnetic resonance imaging or computed tomography.