A Kangaroo Spine Lumbar Motion Segment Model: Biomechanical Analysis of a Novel In Situ Curing Nucleus Replacement Device

Abstract:

This in vitro study compared the effects of nucleotomy alone, with nucleotomy then implantation with a novel nucleus replacement device (D3 device) in a single segment kangaroo spine model. This study utilised dynamic biaxial biomechanical testing of intact, nucleotomy and nucleus replacement implant conditions to evaluate the kinematic behaviour of the single segment kangaroo lumbar spine. Studies have examined the biomechanical efficacy of invasive treatments such as Total Disc Replacement and Intervertebral Fusion for the treatment of chronic low back pain, however no studies to date have investigated the biomechanical effects of a novel elastomeric compressive load sharing nucleus replacement device. Kangaroo lumbar spine motion segments with all musculature, ligamentous tissue and posterior elements removed, were tested in intact state prior to undergoing nucleotomy or nucleotomy then nucleus implantation using the D3 device. All specimens were tested in flexion-extension and lateral-bending; Range of motion (ROM), Neutral Zone (NZ), Hysteresis (H), and Elastic Stiffness (ES) were evaluated. Nucleotomised motion segments demonstrated a 30% to 90% increase in ROM, NZ, H, but not ES for all Flexion-Extension testing conditions and in Lateral Bending test conditions when compared to intact state. Implantation of the nucleus replacement device demonstrated no significant difference when compared to intact state except for H during Lateral Bending testing conditions when compared to the intact state. Therefore, there was a significant increase in ROM, NZ, and H after Nucleotomy during Flexion-Extension motions and an increase in ROM alone during lateral bending motions in the single segment kangaroo spine model. These changes return to that of the intact state with the placement of a novel nucleus replacement device. Our data suggest that the D3 device tested can restore the kinematic changes of a degenerated disc represented by the nucleotomised single motion segment.

• Periodical: Journal of Biomimetics, Biomaterials and Tissue Engineering (Volume 9)
• Pages: 25-35
• DOI: https://doi.org/10.4028/www.scientific.net/JBBTE.9.25
• Online since: January 2011
• Authors: Tamer S. Sabet, Ronald Ho, Jonathan Choi, Philip Boughton, Ashish D. Diwan
• Keywords: Biomechanics, Degenerative Disc Disease, Internal Disc Disruption, Kangaroo Spine, Motion Segment, Nucleotomy, Nucleus Replacement, Spondylosis

References

[1] Adams MA, Dolan P. Journal of Biomechanics 2005; 38: 1972-83.

[2] Auerbach JD. Spine 2007; 32: 527-36.

[3] Battie MC, Videman T, Gibbons LE, et al. Spine. 1995; 20: 2601-12.

[4] Brown KR, Pollintine P, Adams MA. Am J Phys Anthropol 2008; 136: 318-26.

[5] Buckwalter JA. Spine 1995; 20: 1307-14.

[6] Carragee EJ, Alamin TF, Miller JL, et al. Spine Journal 2005; 5: 24-35.

[7] Clarke E, Appleyard R, Bilston LE. Spine 2007; 32: 2970-9.

[8] Clays E, De Bacquer D, Leynen F, et al. Spine 2007; 32: 262-8.

[9] Cunningham BW, Gordon JD, Dmitriev AE, et al. Spine 2003; 28: S110-S7.

[10] Eyre D, Benya P, Buckwalter J, et al. The intervertebral disk: basic science perspectives. In: Frymoyer JW, Gordon SL, eds. New Perspectives on Low Back Pain. Park Ridge, IL: American Academy of Orthopaedic Surgeons 1989: 147–207.

[11] Eysel P, Rompe JD, Schoenmayr R, et al. Acta Neurochirurgica 1999; 141(10): 1083-7.

DOI: 10.1007/s007010050486

[12] Grotle M, Vollestad NK, JI. B. Spine 2006 31: 1038-46.

[13] Henschke N, Maher CG, Refshauge KM, et al. BMJ 2008; 337: a171-8.

[14] Huang RC, Girardi FP, Cammisa FP, Jr., et al. Journal of Spinal Disorders & Techniques 2003; 16: 435-40.

[15] Huang RC, Sandhu HS, Gibson JN, et al. Orthopedic Clinics of North America 2005; 35: 33-42.

[16] Kim DH. Journal of Neurosurgery-Spine 2007; 7: 131-8.

[17] Kjaer P, Korsholm L, Bendix T, et al. European Spine Journal 2006; 15: 1312-9.

[18] Little JP, Adam CJ, Evans JH, et al. J Biomech 2007; 40: 2744-51.

[19] McAfee PCC, Bryan. Dmitriev, Anton. Hu, Niabin. Woo, Kim Seok. Cappuccino, Andy. Pimenta, Luiz. . [Miscellaneous Article]. Spine 2003; 28: S176-S85.

[20] Mimura M, Panjabi M, Oxland T, et al. Spine. Vol. 1994; 19: 1371-80.

[21] Panjabi MM. Spine 2007; 32: 959-66.

[22] Panjabi MM. European Spine Journal 2006; 15: 668-76.

[23] Panjabi MM. Journal of Electromyography and Kinesiology 2003; 13: 371-79.

[24] Pengel L, Herbert R, Maher C, et al. BMJ 2003; 327: 323.

[25] Pollintine P, Dolan P, Tobias JH, et al. Spine 2004; 29: 774-82.

[26] Pollintine P, Przybyla AS, Dolan P, et al. J Biomech 2004; 37: 197-204.

[27] Rohlmann A, Zander T, Schmidt H, et al. J Biomech 2006; 39: 2484-90.

[28] Rubin DI. Epidemiology and risk factors for spine pain. Neurologic Clinics 2007; 25: 353-71.

DOI: 10.1016/j.ncl.2007.01.004

[29] Shim CS, Lee SH, Shin HD, et al. Spine 2007; 32: 1012-8.

[30] Videman T, Battie MC, Ripatti S, et al. Spine 2006; 31: 671-8.

[31] Walker BF, Muller R, Grant WD. Asia Pac J Public Health 2003; 15: 79-87.

[32] White A, Panjabi M. Clinical Biomechanics of the Spine. 1990; 2nd Edn: JB Lippincott Company.

[33] Wilke H, Heuer F, Neidlinger-Wilke C, et al. Eur Spine J 2006; 15: S433-8.

[34] Wilke HJ. Spine 1997; 22: 2365-74.

[35] Wilke HJ, Kavanagh S, Neller S, et al. J Neurosurg 2001; 95: 208-14.

[36] Wilke HJ, Krischak ST, Wenger KH, et al. Eur Spine J 1997; 6: 129-37.

[37] Zhao F, Pollintine P, Hole B, et al. Spine 2005; 30: 2621-30.

[38] Zigler J, Delamarter R, Spivak JM, et al. Spine 2007; 32: 1155-62.