Single-Level In Vitro Kinematic Comparison of Novel Inline Cervical Interbody Devices With Intervertebral Screw, Anchor, or Blade

Global Spine J. 2019 Oct;9(7):697-707. doi: 10.1177/2192568219833055. Epub 2019 Feb 28.

Abstract

Study design: In vitro cadaveric biomechanical study.

Objective: To compare the biomechanics of integrated anchor and blade versus traditional screw fixation techniques for interbody fusion.

Methods: Fifteen cadaveric cervical spines were divided into 3 equal groups (n = 5). Each spine was tested: intact, after discectomy (simulating an injury model), interbody spacer alone (S), integrated interbody spacer (iSA), and integrated spacer with lateral mass screw and rod fixation (LMS+iS). Each treatment group included integrated spacers with either screw, anchor, or blade integrated spacers. Constructs were tested in flexion-extension (FE), lateral bending (LB), and axial rotation (AR) under pure moments (±1.5 N m).

Results: Across all 3 planes, the following range of motion trend was observed: Injured > Intact > S > iSA > LMS+iS. In FE and LB, integrated anchor and blade significantly decreased motion compared with intact and injured conditions, before and after supplemental posterior fixation (P < .05). Comparing tested devices revealed biomechanical equivalence between screw, anchor, and blade fixation methods in all loading modes (P > .05).

Conclusion: All integrated interbody devices reduced intact and injured motion; lateral mass screws and rods further stabilized the single motion segment. Comparing screw, anchor, or bladed integrated anterior cervical discectomy and fusion spacers revealed no significant differences.

Keywords: ACDF; biomechanics; cadaver.