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Comparison of anterior column reconstruction techniques after en bloc spondylectomy: a finite element study – Lumbar Fusion

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The article discusses a study that compares different vertebral body replacement (VBR) devices used in total en bloc spondylectomy (TES) surgeries for spinal tumors. The devices examined include a femur graft, a polyetheretherketone implant (PEEK-IMP-C), a titan mesh cage (MESH-C), and a polymethylmethacrylate replacement (PMMA-C). The researchers used a finite element model of the lumbar spine to assess biomechanical parameters such as rotational stiffness, segmental range of motion (ROM), and von Mises stress for the different VBRs. The results showed that all models provided initial stability, but the PMMA-C had the highest stiffness and the lowest segmental ROM. Furthermore, the PMMA-C and PEEK-IMP-C had similar maximum endplate stress, which was lower than that of the MESH-C. The study suggests that the PMMA-C offers similar or better primary spinal stability compared to other VBRs, potentially due to its larger contact surface and adaptability to the patient’s anatomy

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

Total en bloc spondylectomy (TES) effectively treats spinal tumors. The surgery requires a vertebral body replacement (VBR), for which several solutions were developed, whereas the biomechanical differences between these devices still need to be completely understood. This study aimed to compare a femur graft, a polyetheretherketone implant (PEEK-IMP-C), a titan mesh cage (MESH-C), and a polymethylmethacrylate replacement (PMMA-C) using a finite element model of the lumbar spine after a TES of…

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Sci Rep. 2023 Oct 31;13(1):18767. doi: 10.1038/s41598-023-45736-6.ABSTRACTTotal en bloc spondylectomy (TES) effectively treats spinal tumors. The surgery requires a vertebral body replacement (VBR), for which several solutions were developed, whereas the biomechanical differences between these devices still need to be completely understood. This study aimed to compare a femur graft, a polyetheretherketone implant (PEEK-IMP-C), a,

Sci Rep. 2023 Oct 31;13(1):18767. doi: 10.1038/s41598-023-45736-6.

ABSTRACT

Total en bloc spondylectomy (TES) effectively treats spinal tumors. The surgery requires a vertebral body replacement (VBR), for which several solutions were developed, whereas the biomechanical differences between these devices still need to be completely understood. This study aimed to compare a femur graft, a polyetheretherketone implant (PEEK-IMP-C), a titan mesh cage (MESH-C), and a polymethylmethacrylate replacement (PMMA-C) using a finite element model of the lumbar spine after a TES of L3. Several biomechanical parameters (rotational stiffness, segmental range of motion (ROM), and von Mises stress) were assessed to compare the VBRs. All models provided adequate initial stability by increasing the rotational stiffness and decreasing the ROM between L2 and L4. The PMMA-C had the highest stiffness for flexion-extension, lateral bending, and axial rotation (215%, 216%, and 170% of intact model), and it had the lowest segmental ROM in the instrumented segment (0.2°, 0.5°, and 0.7°, respectively). Maximum endplate stress was similar for PMMA-C and PEEK-IMP-C but lower for both compared to MESH-C across all loading directions. These results suggest that PMMA-C had similar or better primary spinal stability than other VBRs, which may be related to the larger contact surface and the potential to adapt to the patient’s anatomy.

PMID:37907570 | PMC:PMC10618450 | DOI:10.1038/s41598-023-45736-6

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Comparison of anterior column reconstruction techniques after en bloc spondylectomy: a finite element study

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Sci Rep. 2023 Oct 31;13(1):18767. doi: 10.1038/s41598-023-45736-6.ABSTRACTTotal en bloc spondylectomy (TES) effectively treats spinal tumors. The surgery requires a vertebral body replacement (VBR), for which several solutions were developed, whereas the biomechanical differences between these devices still need to be completely understood. This study aimed to compare a femur graft, a polyetheretherketone implant (PEEK-IMP-C), a
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