In the thoracolumbar region, between 7% and 30% of spinal fusion failures are at risk for pseudarthrosis. From a biomechanical perspective, the nonconformity of the intervertebral graft to the endplate surface could contribute to pseudarthrosis, given suboptimal stress distributions. The objective of this study was to quantify the effect of endplate-graft conformation on endplate stress distribution, maximum Von Mises stress development, and stability. The study design used an experimentally validated finite element (FE) model of the L4–L5 functional spinal unit to simulate two types of interbody grafts (cortical bone and polycaprolactone (PCL)-hydroxyapatite (HA) graft), with and without endplate-conformed surfaces. Two case studies were completed. In Case Study I, the endplate-conformed grafts and nonconformed grafts were compared under without posterior instrumentation condition, while in Case Study II, the endplate-conformed and nonconformed grafts were compared with posterior instrumentation. In both case studies, the results suggested that the increased endplate-graft conformity reduced the maximum stress on the endplate, created uniform stress distribution on endplate surfaces, and reduced the range of motion of L4–L5 segments by increasing the contact surface area between the graft and the endplate. The stress distributions in the endplate suggest that the load sharing is greater with the endplate-conformed PCL-HA graft, which might reduce the graft subsidence possibility.
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June 2013
Research-Article
Biomechanical Evaluation of an Endplate-Conformed Polycaprolactone-Hydroxyapatite Intervertebral Fusion Graft and Its Comparison With a Typical Nonconformed Cortical Graft
Anand K. Agarwal,
Vijay K. Goel,
Eda D. Yildirim
Eda D. Yildirim
1
e-mail: Eda.YildirimAyan@utoledo.edu
Engineering Center for Orthopaedic Research Excellence (E-CORE),
Departments of Bioengineering and Orthopaedic Surgery,
Colleges of Engineering and Medicine,
Engineering Center for Orthopaedic Research Excellence (E-CORE),
Departments of Bioengineering and Orthopaedic Surgery,
Colleges of Engineering and Medicine,
University of Toledo
,Toledo
, OH 43606
1Corresponding author. Present address: 5051 Nitschke Hall MS 303, 2801 W. Bancroft St., Toledo, OH 43606-3390.
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Aakash Agarwal
Vivek Palepu
e-mail: VivekPalepu@gmail.com
Anand K. Agarwal
e-mail: Anand.Agarwal@utoledo.edu
Vijay K. Goel
e-mail: Vijay.Goel@utoledo.edu
Eda D. Yildirim
e-mail: Eda.YildirimAyan@utoledo.edu
Engineering Center for Orthopaedic Research Excellence (E-CORE),
Departments of Bioengineering and Orthopaedic Surgery,
Colleges of Engineering and Medicine,
Engineering Center for Orthopaedic Research Excellence (E-CORE),
Departments of Bioengineering and Orthopaedic Surgery,
Colleges of Engineering and Medicine,
University of Toledo
,Toledo
, OH 43606
1Corresponding author. Present address: 5051 Nitschke Hall MS 303, 2801 W. Bancroft St., Toledo, OH 43606-3390.
Contributed by the Bioengineering Division of ASME for publication in the JOURNAL OF BIOMECHANICAL ENGINEERING. Manuscript received September 25, 2012; final manuscript received March 4, 2013; accepted manuscript posted March 8, 2013; published online May 9, 2013. Assoc. Editor: Brian D. Stemper.
J Biomech Eng. Jun 2013, 135(6): 061005 (9 pages)
Published Online: May 9, 2013
Article history
Received:
September 25, 2012
Revision Received:
March 4, 2013
Accepted:
March 8, 2013
Citation
Agarwal, A., Palepu, V., Agarwal, A. K., Goel, V. K., and Yildirim, E. D. (May 9, 2013). "Biomechanical Evaluation of an Endplate-Conformed Polycaprolactone-Hydroxyapatite Intervertebral Fusion Graft and Its Comparison With a Typical Nonconformed Cortical Graft." ASME. J Biomech Eng. June 2013; 135(6): 061005. https://doi.org/10.1115/1.4023988
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