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Experimental measurements of micromotions of the cementless intervertebral disc prostheses in the cadaver bone

      Highlights

      • Two groups were compared depending on the anchoring (spikes vs. fin).
      • Two groups were compared regarding the bearing concept (non/semi- vs. constrained).
      • Majority of the implants showed values clearly below 200 μm in all planes.
      • Implants with spikes anchoring und non-constrained concept might more adventurous.

      Abstract

      Background

      Sufficient primary stability is mandatory for successful bony prosthetic incorporation. Therefore, defined micromotion values of 150 μm should not be exceeded as higher values might compromise the ingrowth of bone trabeculae to the implant surface. The aim of this study was to evaluate the primary stability of different cementless disc prosthesis in a cadaver model.

      Methods

      Four different implants with different anchoring and bearing concept were tested with a target level of L4/5. 26 specimens were randomly allocated to 1 of the 4 different implants with 6 speciments in each group. Two groups were formed depending on the anchoring (spikes vs. fin) and bearing concept (non−/semi- vs. constrained). Each implant was tested regarding primary stability in a hydraulic simulator allowing simultaneous polyaxial segment movements and axial loading. The measurements were recorded on the lower plate of the prosthesis.

      Findings

      The majority of the implants showed micromotion values below 200 μm in all planes. Only one prosthesis presented borderline longitudinal amplitudes that were significant higher than the other planes. Furthermore, significant differences were observed in the sagittal plane when comparing spike and keel anchoring. Spike anchoring implants showed superior tresults to keel anchoring implants (40 μm vs. 55 μm; p = .039), while the non−/semi-constrained bearing concept was more advantageous compared to constrained group (40 μm vs. 63 μm; p = .001).

      Interpretation

      Spike anchoring and non-constrained implants might provide better primary stability.

      Keywords

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