Changes in cadaveric cancellous vertebral bone strength in relation to time. A biomechanical investigation.

摘要

STUDY DESIGN: A biomechanical study was conducted during a 3.5-day period to test for changes occurring in pullout strengths of cancellous screws inserted into human cadaveric vertebral bodies. OBJECTIVES: To quantify, within the testing time of 3.5 days, the possible changes to the mechanical properties of cadaveric vertebral bodies, resulting from structural degradation caused by postmortem, time-dependent, autolytic processes during mechanical testing of implant-bone biomechanics. SUMMARY OF BACKGROUND DATA: Biomechanical testing of whole spinal implants and analysis of the screw-bone interface of spinal implants is an area of clinical interest that frequently requires the use of cadaveric spine specimens. Changes in vertebral bone properties during the testing period may invalidate experimental results, but no data are available on degradation of bone during the testing period. METHODS: Anterior oblique cancellous screws were inserted into human vertebral bodies from which the ventral cortex had been removed. The pullout strength was measured at 0, 24, 60, and 84 hours after insertion. The tests were performed on 48 human vertebral bodies, which were stored by freezing to -23 C, thawed for testing, and kept at room temperature during the testing time for as long as 84 hours. RESULTS: The axial pullout strength showed no statistically significant change during 84 hours (P = 0.15). There were no significant differences attributable to vertebral level from T4 to L4, probably because the ventral cortices had been removed (P = 0.7). CONCLUSIONS: During 3.5 days, there were no changes in pullout strength of vertebral cancellous bone. In biomechanical studies during a maximum period of 3 days with a small number of cadaveric spines (e.g., four spine specimen) the time-dependent changes in pullout strength play a less significant role than do the interspine differences. Interspine differences should be regarded as an important factor to be considered in the design of biomechanical tests.