The Biomechanical Significance of Anterior Column Support in a Simulated Single-Level Spinal Fusion

Abstract

This study examines the biomechanical effects of interbody cages and variations in posterior rod diameter in a simulated single-level spinal fusion. A single-level spinal fusion model composed of polyethylene cylinders, posterior pedicular instrumentation, and variously positioned single or dual interbody cages was used for biomechanical testing. Constructs were tested under compressive flexural load, with measurement of stiffness, rod strain, cage strain, and intracage pressure. A strong linear correlation emerged between the mean construct stiffness and cage positioning within the sagittal plane that was inversely related to posterior rod strain. Two small titanium mesh cages were equivalent to one large cage. In a single-level spine model, the presence of and sagittal position of interbody cages significantly influences overall construct stiffness. Cage strain increased with more anterior positions and was inversely related to rod strain.