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Biomechanical Evaluation Of A Novel Biomimetic Artificial Intervertebral Disc In Canine Cervical Cadaveric Spines – Cervical Disc Replacement

The article discusses a study that aimed to assess the biomechanical effect of a biomimetic artificial intervertebral cervical disc replacement (bioAID) on the kinematic behavior of the canine spine. The bioAID was developed to mimic the complex deformation kinematics of a natural disc and consists of a hydrogel core, fiber jacket, and titanium endplates. The study used canine cadaveric specimens and tested their spinal motion in three conditions: intact, after bioAID disc replacement, and after interbody fusion. The results showed that the bioAID retained the shape of the moment-rotation curves and had similar range of motion (ROM) values to the intact condition in flexion-extension and axial rotation. The adjacent levels to the bioAID-treated segment also showed similar ROM values, while the levels adjacent to the fused segment had increased motion. The study concluded that the bioAID can mimic the kinematic behavior of the replaced disc and may be a promising alternative treatment for severely degenerated intervertebral discs

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : finest treatment clinic in UK

Published article

This study indicates that the bioAID can mimic the kinematic behavior of the replaced intervertebral disc and preserves that for the adjacent levels better than fusion. As a result, CDR using the novel bioAID is a promising alternative treatment for replacing severely degenerated intervertebral discs.

Cervical Disc Replacement Surgery Expert. Best Spinal Surgeon UK
Abstract Background context: Cervical disc replacement (CDR) aims to restore motion of the treated level to reduce the risk of adjacent segment disease (ASD) compared with spinal fusion. However, first-generation articulating devices are unable to mimic the complex deformation kinematics of a natural disc. Thus, a biomimetic artificial intervertebral CDR (bioAID), containing a hydroxyethylmethacrylate (HEMA)-sodium,

Abstract

Background context: Cervical disc replacement (CDR) aims to restore motion of the treated level to reduce the risk of adjacent segment disease (ASD) compared with spinal fusion. However, first-generation articulating devices are unable to mimic the complex deformation kinematics of a natural disc. Thus, a biomimetic artificial intervertebral CDR (bioAID), containing a hydroxyethylmethacrylate (HEMA)-sodium methacrylate (NaMA) hydrogel core representing the nucleus pulposus, an ultra-high-molecular-weight-polyethylene fiber jacket as annulus fibrosus, and titanium endplates with pins for primary mechanical fixation, was developed.

Purpose: To assess the initial biomechanical effect of the bioAID on the kinematic behavior of the canine spine, an ex vivo biomechanical study in 6-degrees-of-freedom was performed.

Study design: A canine cadaveric biomechanical study.

Methods: Six cadaveric canine specimens (C3-C6) were tested in flexion-extension (FE), lateral bending (LB) axial rotation (AR) using a spine tester in three conditions: intact, after C4-C5 disc replacement with bioAID, and after C4-C5 interbody fusion. A hybrid protocol was used where first the intact spines were subjected to a pure moment of ±1 Nm, whereafter the treated spines were subjected to the full range of motion (ROM) of the intact condition. 3D segmental motions at all levels were measured while recording the reaction torsion. Biomechanical parameters studied included ROM, neutral zone (NZ), and intradiscal pressure (IDP) at the adjacent cranial level (C3-C4).

Results: The bioAID retained the sigmoid shape of the moment-rotation curves with a NZ similar to the intact condition in LB and FE. Additionally, the normalized ROMs at the bioAID-treated level were statistically equivalent to intact during FE and AR while slightly decreased in LB. At the two adjacent levels, ROMs showed similar values for the intact compared to the bioAID for FE and AR and an increase in LB. In contrast, levels adjacent to the fused segment showed an increased motion in FE and LB as compensation for the loss of motion at the treated level. The IDP at the adjacent C3-C4 level after implantation of bioAID was close to intact values. After fusion, increased IDP was found compared with intact but did not reach statistical significance.

This study indicates that the bioAID can mimic the kinematic behavior of the replaced intervertebral disc and preserves that for the adjacent levels better than fusion. As a result, CDR using the novel bioAID is a promising alternative treatment for replacing severely degenerated intervertebral discs.

Keywords: biomechanical; biomimetic artificial disc; cervical spine; kinematics; total disc replacement.

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Read the original publication:

Biomechanical evaluation of a novel biomimetic artificial intervertebral disc in canine cervical cadaveric spines

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Abstract Background context: Cervical disc replacement (CDR) aims to restore motion of the treated level to reduce the risk of adjacent segment disease (ASD) compared with spinal fusion. However, first-generation articulating devices are unable to mimic the complex deformation kinematics of a natural disc. Thus, a biomimetic artificial intervertebral CDR (bioAID), containing a hydroxyethylmethacrylate (HEMA)-sodium

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