Combined Orthopaedic and Neurosurgery Spine Program, London Health Science Centre, Victoria Hospital, 800 Commissioners Road E (RM A6-144), London, ON, N6A 5W9, Canada.
Schulich School of Medicine, Western University, London, ON, Canada.
Sci Rep. 2022 Jul 22;12(1):12505. doi: 10.1038/s41598-022-16895-9.
Biomechanical study. To evaluate the performance of the contact surface for 3D printed patient-specific cages using CT-scan 3D endplate reconstructions in comparison to the contact surface of commercial cages. Previous strategies to improve the surface of contact between the device and the endplate have been employed to attenuate the risk of cage subsidence. Patient-specific cages have been used to help, but only finite-element studies have evaluated the effectiveness of this approach. There is a possible mismatch between the CT-scan endplate image used to generate the cage and the real bony endplate anatomy that could limit the performance of the cages. A cadaveric model is used to investigate the possible mismatch between 3D printed patient-specific cages and the endplate and compare them to commercially available cages (Medtronic Fuse and Capstone). Contact area and contact stress were used as outcomes. When PS cage was compared to the Capstone cage, the mean contact area obtained was 100 ± 23.6 mm and 57.5 ± 13.7 mm, respectively (p < 0.001). When compared to the Fuse cage, the mean contact area was 104.8 ± 39.6 mm and 55.2 ± 35.1 mm, respectively(p < 0.001). Patient-specific cages improve the contact area between the implant and the endplate surface, reducing the contact stress and the risk of implant subsidence during LIF surgeries.
生物力学研究。评估使用 CT 扫描 3D 终板重建进行 3D 打印患者专用笼的接触面性能，与商业笼的接触面进行比较。为了降低笼下沉的风险，已经采用了多种改善设备与终板之间接触表面的策略。已经使用了患者专用笼来辅助，但只有有限元研究评估了这种方法的有效性。用于生成笼的 CT 扫描终板图像与实际骨性终板解剖结构之间可能存在不匹配，这可能会限制笼的性能。使用尸体模型来研究 3D 打印患者专用笼与终板之间可能存在的不匹配，并将其与市售笼（美敦力融合和 Capstone）进行比较。使用接触面积和接触压力作为结果。当 PS 笼与 Capstone 笼进行比较时，分别获得的平均接触面积为 100±23.6mm 和 57.5±13.7mm（p<0.001）。当与 Fuse 笼进行比较时，平均接触面积分别为 104.8±39.6mm 和 55.2±35.1mm（p<0.001）。患者专用笼可改善植入物与终板表面之间的接触面积，降低 LIF 手术中植入物下沉的接触压力和风险。
