Cargando…
ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design
STUDY DESIGN: Biomechanical study in cadaveric specimens. BACKGROUND: The commercially available lumbar disc prostheses do not reproduce the intact disc's Instantaneous centre of Rotation (ICR), thus inducing an overload on adjacent anatomical structures, promoting secondary degeneration. AIM:...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820058/ https://www.ncbi.nlm.nih.gov/pubmed/35141586 http://dx.doi.org/10.1016/j.xnsj.2020.100016 |
_version_ | 1784646168153686016 |
---|---|
author | Vanaclocha-Saiz, Amparo Atienza, Carlos M. Vanaclocha, Vicente Belloch, Vicente Santabarbara, Juan Manuel Jordá-Gómez, Pablo Vanaclocha, Leyre |
author_facet | Vanaclocha-Saiz, Amparo Atienza, Carlos M. Vanaclocha, Vicente Belloch, Vicente Santabarbara, Juan Manuel Jordá-Gómez, Pablo Vanaclocha, Leyre |
author_sort | Vanaclocha-Saiz, Amparo |
collection | PubMed |
description | STUDY DESIGN: Biomechanical study in cadaveric specimens. BACKGROUND: The commercially available lumbar disc prostheses do not reproduce the intact disc's Instantaneous centre of Rotation (ICR), thus inducing an overload on adjacent anatomical structures, promoting secondary degeneration. AIM: To examine biomechanical testing of cadaveric lumbar spine specimens in order to evaluate and define the ICR of intact lumbar discs. MATERIAL AND METHODS: Twelve cold preserved fresh human cadaveric lumbosacral spine specimens were subjected to computerized tomography (CT), magnetic resonance imaging (MRI) and biomechanical testing. Kinematic studies were performed to analyse range of movements in order to determine ICR. RESULTS: Flexoextension and lateral bending tests showed a positive linear correlation between the angle rotated and the displacement of the ICR in different axes. DISCUSSION: ICR has not been taken into account in any of the available literature regarding lumbar disc prosthesis. Considering our results, neither the actual ball-and-socket nor the withdrawn elastomeric nucleus models fit the biomechanics of the lumbar spine, which could at least in part explain the failure rates of the implants in terms of postoperative failed back syndrome (low back pain). It is reasonable to consider then that an implant should also adapt the equations of the movement of the intact ICR of the joint to the post-surgical ICR. CONCLUSIONS: This is the first cadaveric study on the ICR of the human lumbar spine. We have shown that it is feasible to calculate and consider this parameter in order to design future prosthesis with improved clinical and biomechanical characteristics. |
format | Online Article Text |
id | pubmed-8820058 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-88200582022-02-08 ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design Vanaclocha-Saiz, Amparo Atienza, Carlos M. Vanaclocha, Vicente Belloch, Vicente Santabarbara, Juan Manuel Jordá-Gómez, Pablo Vanaclocha, Leyre N Am Spine Soc J Basic Science STUDY DESIGN: Biomechanical study in cadaveric specimens. BACKGROUND: The commercially available lumbar disc prostheses do not reproduce the intact disc's Instantaneous centre of Rotation (ICR), thus inducing an overload on adjacent anatomical structures, promoting secondary degeneration. AIM: To examine biomechanical testing of cadaveric lumbar spine specimens in order to evaluate and define the ICR of intact lumbar discs. MATERIAL AND METHODS: Twelve cold preserved fresh human cadaveric lumbosacral spine specimens were subjected to computerized tomography (CT), magnetic resonance imaging (MRI) and biomechanical testing. Kinematic studies were performed to analyse range of movements in order to determine ICR. RESULTS: Flexoextension and lateral bending tests showed a positive linear correlation between the angle rotated and the displacement of the ICR in different axes. DISCUSSION: ICR has not been taken into account in any of the available literature regarding lumbar disc prosthesis. Considering our results, neither the actual ball-and-socket nor the withdrawn elastomeric nucleus models fit the biomechanics of the lumbar spine, which could at least in part explain the failure rates of the implants in terms of postoperative failed back syndrome (low back pain). It is reasonable to consider then that an implant should also adapt the equations of the movement of the intact ICR of the joint to the post-surgical ICR. CONCLUSIONS: This is the first cadaveric study on the ICR of the human lumbar spine. We have shown that it is feasible to calculate and consider this parameter in order to design future prosthesis with improved clinical and biomechanical characteristics. Elsevier 2020-07-20 /pmc/articles/PMC8820058/ /pubmed/35141586 http://dx.doi.org/10.1016/j.xnsj.2020.100016 Text en © 2020 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Basic Science Vanaclocha-Saiz, Amparo Atienza, Carlos M. Vanaclocha, Vicente Belloch, Vicente Santabarbara, Juan Manuel Jordá-Gómez, Pablo Vanaclocha, Leyre ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design |
title | ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design |
title_full | ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design |
title_fullStr | ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design |
title_full_unstemmed | ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design |
title_short | ICR in human cadaveric specimens: An essential parameter to consider in a new lumbar disc prosthesis design |
title_sort | icr in human cadaveric specimens: an essential parameter to consider in a new lumbar disc prosthesis design |
topic | Basic Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820058/ https://www.ncbi.nlm.nih.gov/pubmed/35141586 http://dx.doi.org/10.1016/j.xnsj.2020.100016 |
work_keys_str_mv | AT vanaclochasaizamparo icrinhumancadavericspecimensanessentialparametertoconsiderinanewlumbardiscprosthesisdesign AT atienzacarlosm icrinhumancadavericspecimensanessentialparametertoconsiderinanewlumbardiscprosthesisdesign AT vanaclochavicente icrinhumancadavericspecimensanessentialparametertoconsiderinanewlumbardiscprosthesisdesign AT bellochvicente icrinhumancadavericspecimensanessentialparametertoconsiderinanewlumbardiscprosthesisdesign AT santabarbarajuanmanuel icrinhumancadavericspecimensanessentialparametertoconsiderinanewlumbardiscprosthesisdesign AT jordagomezpablo icrinhumancadavericspecimensanessentialparametertoconsiderinanewlumbardiscprosthesisdesign AT vanaclochaleyre icrinhumancadavericspecimensanessentialparametertoconsiderinanewlumbardiscprosthesisdesign |