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Research ArticleArticles

Integrated Fixation Cage Loosening Under Fatigue Loading

Srinidhi Nagaraja and Vivek Palepu
International Journal of Spine Surgery January 2017, 11 (3) 20; DOI: https://doi.org/10.14444/4020
Srinidhi Nagaraja
US Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Applied Mechanics, Silver Spring, Maryland, USA
PhD
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Vivek Palepu
US Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Applied Mechanics, Silver Spring, Maryland, USA
PhD
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  • Fig. 1
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    Fig. 1

    (a) Anterior plate and (b) Integrated fixation cage designs used for the fatigue testing.

  • Fig. 2
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    Fig. 2

    Steps involved in creating three dimensional (3D) volumes of screw holes from post-fatigue micro-CT images of (a) Integrated fixation cage and (b) Anterior plate constructs.

  • Fig. 3
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    Fig. 3

    Optical images of (a) anterior plate and cage and (b) integrated fixation cage (IFC) constructs after fatigue testing. Medial screw back out is visible in the IFC construct.

  • Fig. 4
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    Fig. 4

    Mean and standard deviations of normalized screw hole volumes for IFC and AP+C constructs. Dotted line represents no change in screw hole volume post-fatigue testing. * indicates significantly greater screw loosening than AP+C (p=0.008).

  • Fig. 5
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    Fig. 5

    Mean and standard deviations of normalized screw hole volumes for medial and lateral screws of IFC and top and bottom screws of AP+C. Dotted line represents no change in screw hole volume post-fatigue testing. *Indicates significantly greater screw loosening (p<0.003).

  • Fig. 6
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    Fig. 6

    Screw loosening after fatigue testing vs. BMD for IFC and AP+C constructs. Linear regression values yielded 18-33% R-squared values (p≥0.11).

Tables

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    Table 1

    Demographic and Lumbar DEXA information for each Cadaver.

    SpecimenSexAgeT-ScoreBMD (g/cm2)
    1M691.21.176
    2M721.51.206
    3M61-2.10.813
    4M710.11.053
    5M85-1.10.923
    6M81-1.60.865
    7M70-1.80.841
    8F70-2.40.782
    9F83-2.90.724
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International Journal of Spine Surgery
Vol. 11, Issue 3
1 Jan 2017
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Integrated Fixation Cage Loosening Under Fatigue Loading
Srinidhi Nagaraja, Vivek Palepu
International Journal of Spine Surgery Jan 2017, 11 (3) 20; DOI: 10.14444/4020

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Integrated Fixation Cage Loosening Under Fatigue Loading
Srinidhi Nagaraja, Vivek Palepu
International Journal of Spine Surgery Jan 2017, 11 (3) 20; DOI: 10.14444/4020
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Keywords

  • micro-CT
  • integrated fixation cage
  • anterior plate
  • cadaver
  • fatigue
  • screw loosening
  • image processing

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