Biomechanical studies on two anterior thoracolumbar implants in cadaveric spines

Study Design. A biomechanical comparison of two commonly used anterior spin al devices: the Smooth Rod Kaneda and the Synthes Anterior Thoracolumbar Sp inal Plate. Objectives. To compare the stability imparted to the human cadaveric spine by the Smooth Rod Kaneda and Synthes Anterior Spinal Plate, ana to assess h ow well these devices withstand fatigue and uni- and bilateral facetectomy. Summary of Background Data. Biomechanical studies on the aforementioned and similar devices have been performed using synthetic, porcine, calf, or dog spines. As of the time of this writing, studies comparing anterior spinal implants using human cadaveric spines are scarce. Methods. An L1 corpectomy was performed on 19 spines. Stabilization was acc omplished by an interbody wooden graft and the application of the Smooth Ro d Kaneda in 10 spines and the Synthes Anterior Spinal Plate in the remainin g 9. Biomechanical testing of the spines was performed in six degrees of fr eedom before and after stabilization, and after fatiguing to 5000 cycles of +/- 3 Nm of flexion and extension. Testing was repeated after unibilateral facetectomy. Results. After stabilization, the Smooth Rod Kaneda was significantly more rigid than the anterior thoracolum-bar spinal plate in extension. After fat igue, the Smooth Rod Kaneda was significantly stiffer than the anterior tho racolumbar spinal plate in flexion, extension, right lateral bending, left lateral bending, and right axial rotation. A significant decrease in stiffn ess was noted with the Synthes device in flexion after bilateral facetectom y compared with the stabilized spine, Conclusions. The Smooth Rod Kaneda device tends to,be stiffer than the ante rior thoracolumbar spinal plate, particularly in extension, exceeding the a nterior thoracolumbar spinal plate in fatigue tolerance. The spine stabiliz ed with the anterior thoracolumbar spinal plate is more susceptible to the destabilizing effect of bilateral facetectomy than that stabilized with the Smooth Rod Kaneda. The additional rigidity encountered with the Smooth Rod Kaneda must be weighed against the simplicity of anterior thoracolumbar sp inal plate application.