The importance of the endplate for interbody cages in the lumbar spine

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Anne PolikeitTracy E Orr

Abstract

Intervertebral cages in the lumbar spine represent an advancement in spinal fusion to relieve low back pain. Different implant designs require different endplate preparations, but the question of to what extent preservation of the bony endplate might be necessary remains unanswered. In this study the effects of endplate properties and their distribution on stresses in a lumbar functional spinal unit were investigated using finite-element analyses. Three-dimensional finite-element models of L2-L3 with and without a cage were used. An anterior approach for a monobloc, box-shaped cage was modelled. The results showed that inserting a cage increased the maximum von Mises stress and changed the load distribution in the adjacent structures. A harder endplate led to increased concentration of the stress peaks and high stresses were propagated further into the vertebral body, into areas that would usually not experience such stresses. This may cause structural changes and provide an explanation for the damage occurring to the underlying bone, as well as for the subsequent subsidence of the cage. Stress distributions were similar for the two endplate preparation techniques of complete endplate preservation and partial endplate removal f...Continue Reading

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Citations

Jun 9, 2005·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Stephen J FergusonAnne Polikeit
Sep 1, 2005·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·M SpruitR M Castelein
Nov 18, 2005·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·P I J M Wuisman, T H Smit
Jan 15, 2008·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Magdalena Müller-GerblUlrich Linsenmeier
Feb 28, 2008·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·R C Mulholland
Sep 16, 2008·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Michaela GstoettnerChristian Michael Bach
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