[BIOMECHANICAL STUDY ON KIDNEY-SHAPED NANO-HYDROXYAPATITE/POLYAMIDE 66 CAGE].

OBJECTIVE

To compare the biomechanical differences between the kidney-shaped nano-hydroxyapatite/polyamide 66 (n-HA/PA66) Cage and the bullet-shaped n-HA/PA66 Cage.

METHODS

L2-L5 spinal specimens were selected from 10 adult male pigs. L2, L3 and L4, L5 served as a motor unit respectively, 20 motor units altogether. They were divided into 4 groups (n = 5): no treatment was given as control group (group A); nucleus pulposus resection was performed (group B); bullet-shaped Cage (group C), and kidney-shaped Cage (group D) were used in transforaminal lumbar interbody fusion (TLIF) through left intervertebral foramen and supplemented by posterior pedicle screw fixation. The intervertebral height (IH) and the position of Cages were observed on the X-ray films. The range of motion (ROM) was measured.

RESULTS

There was no significant difference in the preoperative IH among 4 groups (F = 0.166, P = 0.917). No significant change was found in IH between at pre- and post-operation in group B (P > 0.05); it increased after operation in groups C and.D, but difference was not statistically significant (P > 0.05). There was no significant difference in the postoperative IH among groups B, C, and D (P > 0.05). The distance from Cage to the left margin was (3.06 ± 0.51) mm in group C (close to the left) and (5.68 ± 0.69) mm in group D (close to the middle), showing significant difference (t = 6.787, P = 0.000). The ROM in all directions were significantly lower in groups C and D than in groups A and B (P < 0.05), and in group A than in group B (P < 0.05). The right bending and compression ROM of group C were significantly higher than those of group D (P < 0.05), but no statistically significant difference was found in the other direction ROM (P > 0.05).

CONCLUSION

The bullet-shaped and kidney-shaped Cages have similar results in restoring IH and maintaining the stability of the spine assisted by internal fixation. Kidney-shaped Cage is more stable than bullet-shaped Cage in the axial compression and the bending load opposite implant, it can be placed in the middle and back of the vertebral body more ideally.