ICR in Human Cadaveric Specimens: An Essential Parameter to Consider in a New Lumbar Disc Prosthesis Design

Overview

Journal N Am Spine Soc J

Date 2022 Feb 10

PMID 35141586

Authors

Amparo Vanaclocha-Saiz

Carlos M Atienza

Vicente Vanaclocha

Vicente Belloch

Juan Manuel Santabarbara

Pablo Jorda-Gomez

Leyre Vanaclocha

Affiliations

Soon will be listed here.

Abstract

Study Design: Biomechanical study in cadaveric specimens.

Background: The commercially available lumbar disc prostheses do not reproduce the intact disc's Instantaneous centre of Rotation (ICR), thus inducing an overload on adjacent anatomical structures, promoting secondary degeneration.

Aim: To examine biomechanical testing of cadaveric lumbar spine specimens in order to evaluate and define the ICR of intact lumbar discs.

Material And Methods: Twelve cold preserved fresh human cadaveric lumbosacral spine specimens were subjected to computerized tomography (CT), magnetic resonance imaging (MRI) and biomechanical testing. Kinematic studies were performed to analyse range of movements in order to determine ICR.

Results: Flexoextension and lateral bending tests showed a positive linear correlation between the angle rotated and the displacement of the ICR in different axes.

Discussion: ICR has not been taken into account in any of the available literature regarding lumbar disc prosthesis. Considering our results, neither the actual ball-and-socket nor the withdrawn elastomeric nucleus models fit the biomechanics of the lumbar spine, which could at least in part explain the failure rates of the implants in terms of postoperative failed back syndrome (low back pain). It is reasonable to consider then that an implant should also adapt the equations of the movement of the intact ICR of the joint to the post-surgical ICR.

Conclusions: This is the first cadaveric study on the ICR of the human lumbar spine. We have shown that it is feasible to calculate and consider this parameter in order to design future prosthesis with improved clinical and biomechanical characteristics.

Citing Articles

ADDISC lumbar disc prosthesis: Analytical and FEA testing of novel implants.

Vanaclocha A, Vanaclocha V, Atienza C, Jorda-Gomez P, Diaz-Jimenez C, Garcia-Lorente J Heliyon. 2023; 9(2):e13540.

PMID: 36816293 PMC: 9929472. DOI: 10.1016/j.heliyon.2023.e13540.

Spinal Biomechanical Modelling in the Process of Lumbar Intervertebral Disc Herniation in Middle-Aged and Elderly.

Zhang X, Zhao Z, Niu C, Ma Z, Hou J, Wang G J Healthc Eng. 2021; 2021:2869488.

PMID: 34745494 PMC: 8570862. DOI: 10.1155/2021/2869488.

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