Prior storage conditions and loading rate affect the in vitro fracture response of spinal segments under impact loading.

Traumatic injuries of the spine are mostly the consequence of rapid overload e.g. impact loading. In vitro investigations on this topic usually encompass biomechanical testing using frozen/thawed specimens and employ quasi-static loading conditions. It is generally accepted that a freezing/thawing cycle does not alter mechanical properties for slow loading rates. However, this has never been investigated for high impact velocities. In order to assess the effects of freezing/thawing and the influence of different impact velocities, we loaded 27 fresh and 15 frozen/thawed cadaveric rabbit spinal segments (intervertebral disc with one third of the adjacent vertebrae) with different impact energies and velocities using a custom-made, dropped-weight loading device. Endplate fractures were assessed by micro-CT scans. Specimen dimensions (disk, bone, and total height) and vertebrae bone density (BV/TV) were compared pre- and post-trauma. Energy absorption by spinal segments was quantified by measuring the initial ball rebound. We found that freezing/thawing increased endplate fracture frequency and decreased the energy absorption of the segments. Higher impact velocities increased the energy absorption, while higher impact energy increased both energy absorption and fracture frequency. Two conclusions are drawn: first, under impact loading, freezing alters permanently the biomechanical response, and second, for different impact velocities, different fracture initiation mechanisms apply. Therefore, quasi-static loading of frozen/thawed spinal segments is not a valid model for traumatic endplate injuries. However, caution should be exercised in extrapolating these findings to human vertebrae until tests on larger vertebrae are performed.