Load-sharing through elastic micro-motion accelerates bone formation and interbody fusion

Publication date: Available online 13 February 2018
Source:The Spine Journal
Author(s): Eric H. Ledet, Glenn P. Sanders, Darryl J. DiRisio, Joseph C. Glennon
BackgroundContext: Achieving a successful spinal fusion requires the proper biologic and biomechanical environment. Optimizing load-sharing in the interbody space can enhance bone formation. For anterior cervical discectomy and fusion (ACDF), loading and motion are largely dictated by the stiffness of the plate which can facilitate a balance between stability and load-sharing. The advantages of load-sharing may be substantial for patients with comorbidities and in multi-level procedures where pseudarthrosis rates are significant.PurposeTo evaluate the efficacy of a novel elastically deformable, continuously load-sharing anterior cervical spinal plate for promotion of bone formation and interbody fusion relative to a translationally dynamic plate.Study Design/SettingAn in vivo animal model was used to evaluate the effects of an elastically deformable spinal plate on bone formation and spine fusion.MethodsFourteen goats underwent an ACDF and received either a translationally dynamic or elastically deformable plate. Animals were followed out to 18 weeks and were evaluated by plain x-ray, CT scan, and undecalcified histology to evaluate the rate and quality of bone formation and interbody fusion.ResultsAnimals treated with the elastically deformable plate demonstrated statistically significantly superior early bone formation relative to the translationally dynamic plate. Trends in the data from 8 to 18 weeks post-operatively suggest that the elastically deformable implant enhanced bony bridging and fusion, but these enhancements were not statistically significant.ConclusionsLoad-sharing through elastic micro-motion accelerates bone formation in the challenging goat ACDF model. The elastically deformable implant used in this study may promote early bony bridging and increased rates of fusion but future studies will be necessary to comprehensively characterize the advantages of load-sharing through micromotion.



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