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[Biomechanical study on lumbar spondylodeses using an internal fixateur consisting of a titanium alloy].

OBJECTIVE
Biomechanical properties of an internal fixateur manufactured of a titanium alloy (Ti-6Al-4V-alloy) to be evaluated in an in vitro setting.


METHOD
Internal fixateurs were inserted into six (four female and two male specimens) human lumar spine segments L2 to L4. Only dorsal instrumentations were performed. Physiological loads were applied (2.0 to 10.0 Nm for torque, 2.0 to 7.5 Nm for extension/flexion and lateral bending). Biomechanical investigations were performed in four settings: Intact specimen without instrumentation, instrumented specimen, instrumented specimen after corpectomy of the middle vertebral body, instrumented specimen after corpectomy of the middle vertebral body with an additional transverse connector.


RESULTS
Stability after instrumentation was increased by 84.7 % for flexion/extension, by 78.2 % for lateral bending and by 43 % for axial torsion. Axial torsion was already less distinct in the physiological specimen. The stability of instrumented specimen after corpectomy was superior to that of intact vertebral segments without internal fixation. Additional application of transverse connectors did not significantly enhance the stiffness of the implant.


CONCLUSION
For the clinical use there is no difference in the biomechanical properties of the titanium fixateur compared to similar constructions made of stainless steel. The possibility of performing MRI- or CT-scans after implantation of titanium implants is a main clinical advantage. The stabilisation after corpectomy is remarkable, so that a sufficient fracture-stabilisation is possible. Based on the data, the application of transverse connectors cannot be recommended.