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Biomechanical Analysis of Range of Motion and Failure Characteristics of Osteoporotic Spinal Compression Fractures in Human Cadaver

BACKGROUND: Vertebroplasty is a treatment for osteoporotic vertebral compression fractures. The optimal location of needle placement for cement injection remains a topic of debate. As such, the authors assessed the effects of location of two types of cement instillations. In addition, the motion and...

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Autores principales: Heary, Robert F, Parvathreddy, Naresh K, Agarwal, Nitin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688860/
https://www.ncbi.nlm.nih.gov/pubmed/29200483
http://dx.doi.org/10.4103/ortho.IJOrtho_147_16
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author Heary, Robert F
Parvathreddy, Naresh K
Agarwal, Nitin
author_facet Heary, Robert F
Parvathreddy, Naresh K
Agarwal, Nitin
author_sort Heary, Robert F
collection PubMed
description BACKGROUND: Vertebroplasty is a treatment for osteoporotic vertebral compression fractures. The optimal location of needle placement for cement injection remains a topic of debate. As such, the authors assessed the effects of location of two types of cement instillations. In addition, the motion and failure modes at the index and adjacent segments were measured. MATERIALS AND METHODS: Seven human osteoporotic cadaver spines (T1-L4), cut into four consecutive vertebral segments, were utilized. Of these, following the exclusion of four specimens not suitable to utilize for analysis, a total of 24 specimens were evaluable. Segments were randomly assigned into four treatment groups: unipedicular and bipedicular injections into the superior quartile or the anatomic center of the vertebra using confidence (Confidence Spinal Cement System(®), DePuy Spine, Raynham, MA, USA) or polymethyl methacrylate. The specimens were subjected to nondestructive pure moments of 5 Nm, in 2.5 Nm increments, using pulleys and weights to simulate six degrees of physiological motion. A follower preload of 200 N was applied in flexion extension. Testing sequence: range of motion (ROM) of intact specimen, fracture creation, cement injection, ROM after cement, and compression testing until failure. Nonconstrained motion was measured at the index and adjacent levels. RESULTS: At the index level, no significant differences were observed in ROM in all treatment groups (P > 0.05). There was a significant increase in adjacent level motion only for the treatment group that received a unipedicular cement injection at the anatomic center. CONCLUSION: The location of the needle (superior or central) and treatment type (unipedicular or bipedicular) had no significant effect on the ROM at the index site. At the adjacent levels, a significant increase occurred with therapy through a unipedicular approach into the centrum of the vertebra at the treated segment.
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spelling pubmed-56888602017-12-01 Biomechanical Analysis of Range of Motion and Failure Characteristics of Osteoporotic Spinal Compression Fractures in Human Cadaver Heary, Robert F Parvathreddy, Naresh K Agarwal, Nitin Indian J Orthop Original Article BACKGROUND: Vertebroplasty is a treatment for osteoporotic vertebral compression fractures. The optimal location of needle placement for cement injection remains a topic of debate. As such, the authors assessed the effects of location of two types of cement instillations. In addition, the motion and failure modes at the index and adjacent segments were measured. MATERIALS AND METHODS: Seven human osteoporotic cadaver spines (T1-L4), cut into four consecutive vertebral segments, were utilized. Of these, following the exclusion of four specimens not suitable to utilize for analysis, a total of 24 specimens were evaluable. Segments were randomly assigned into four treatment groups: unipedicular and bipedicular injections into the superior quartile or the anatomic center of the vertebra using confidence (Confidence Spinal Cement System(®), DePuy Spine, Raynham, MA, USA) or polymethyl methacrylate. The specimens were subjected to nondestructive pure moments of 5 Nm, in 2.5 Nm increments, using pulleys and weights to simulate six degrees of physiological motion. A follower preload of 200 N was applied in flexion extension. Testing sequence: range of motion (ROM) of intact specimen, fracture creation, cement injection, ROM after cement, and compression testing until failure. Nonconstrained motion was measured at the index and adjacent levels. RESULTS: At the index level, no significant differences were observed in ROM in all treatment groups (P > 0.05). There was a significant increase in adjacent level motion only for the treatment group that received a unipedicular cement injection at the anatomic center. CONCLUSION: The location of the needle (superior or central) and treatment type (unipedicular or bipedicular) had no significant effect on the ROM at the index site. At the adjacent levels, a significant increase occurred with therapy through a unipedicular approach into the centrum of the vertebra at the treated segment. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5688860/ /pubmed/29200483 http://dx.doi.org/10.4103/ortho.IJOrtho_147_16 Text en Copyright: © 2017 Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Heary, Robert F
Parvathreddy, Naresh K
Agarwal, Nitin
Biomechanical Analysis of Range of Motion and Failure Characteristics of Osteoporotic Spinal Compression Fractures in Human Cadaver
title Biomechanical Analysis of Range of Motion and Failure Characteristics of Osteoporotic Spinal Compression Fractures in Human Cadaver
title_full Biomechanical Analysis of Range of Motion and Failure Characteristics of Osteoporotic Spinal Compression Fractures in Human Cadaver
title_fullStr Biomechanical Analysis of Range of Motion and Failure Characteristics of Osteoporotic Spinal Compression Fractures in Human Cadaver
title_full_unstemmed Biomechanical Analysis of Range of Motion and Failure Characteristics of Osteoporotic Spinal Compression Fractures in Human Cadaver
title_short Biomechanical Analysis of Range of Motion and Failure Characteristics of Osteoporotic Spinal Compression Fractures in Human Cadaver
title_sort biomechanical analysis of range of motion and failure characteristics of osteoporotic spinal compression fractures in human cadaver
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688860/
https://www.ncbi.nlm.nih.gov/pubmed/29200483
http://dx.doi.org/10.4103/ortho.IJOrtho_147_16
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