The polymethyl methacrylate cervical cage for treatment of cervical disk disease Part III. Biomechanical properties.

BACKGROUND In a previous article, we used the PMMA cervical cage in the treatment of single-level cervical disk disease and the preliminary clinical results were satisfactory. However, the mechanical properties of the PMMA cage were not clear. Therefore, we designed a comparative in vitro biomechanical study to determine the mechanical properties of the PMMA cage. METHODS The PMMA cervical cage and the Solis PEEK cervical cage were compressed in a materials testing machine to determine the mechanical properties. RESULTS The compressive yield strength of the PMMA cage (7030 +/- 637 N) was less than that of the Solis polymer cervical cage (8100 +/- 572 N). The ultimate compressive strength of the PMMA cage (8160 +/- 724 N) was less than that of the Solis cage (9100 +/- 634 N). The stiffness of the PMMA cervical cage (8106 +/- 817 N/mm) was greater than that of the Solis cage (6486 +/- 530 N/mm). The elastic modulus of the PMMA cage (623 +/- 57 MPa) was greater than that of the Solis cage (510 +/- 42 MPa). The elongation of PMMA cage (43.5 +/- 5.7%) was larger than that of the Solis cage (36.1 +/- 4.3%). CONCLUSIONS Although the compressive yield strength and ultimate compressive strength of the PMMA cervical cage were less than those of the Solis polymer cage, the mechanical properties are better than those of the cervical vertebral body. The PMMA cage is strong and safe for use as a spacer for cervical interbody fusion. Compared with other cage materials, the PMMA cage has many advantages and no obvious failings at present. However, the PMMA cervical cage warrants further long-term clinical study.

[1]  Bernard Saltzberg,et al.  Experimental studies of brain and neck injury , 1981 .

[2]  S. Belkoff,et al.  An in vitro biomechanical evaluation of bone cements used in percutaneous vertebroplasty. , 1999, Bone.

[3]  Narayan Yoganandan,et al.  Cervical spine injuries from motor vehicle accidents , 1990 .

[4]  S. L. Griffith,et al.  The Bagby and Kuslich Method of Lumbar Interbody Fusion: History, Techniques, and 2‐Year Follow‐up Results of a United States Prospective, Multicenter Trial , 1998, Spine.

[5]  L. Claes,et al.  [Stabilizing effect and sintering tendency of 3 different cages and bone cement for fusion of cervical vertebrae segments]. , 2002, Der Orthopade.

[6]  A D Steffee,et al.  A Carbon Fiber Implant to Aid Interbody Lumbar Fusion: Two‐Year Clinical Results in the First 26 Patients , 1993, Spine.

[7]  A Sances,et al.  Compression injuries of the cervical spine: a biomechanical analysis. , 1983, Neurosurgery.

[8]  A. Sances,et al.  Dynamic Characteristics of the Human Cervical Spine , 1995 .

[9]  L. Claes,et al.  Stabilisierende Wirkung und Sinterungstendenz dreier unterschiedlicher Cages und Knochenzement zur Fusion von Halswirbelsäulensegmenten , 2014, Der Orthopäde.

[10]  B S Myers,et al.  Dynamic responses of the head and cervical spine to axial impact loading. , 1996, Journal of biomechanics.

[11]  C D Ray,et al.  Threaded Titanium Cages for Lumbar Interbody Fusions , 1997, Spine.

[12]  G. Bagby Arthrodesis by the distraction-compression method using a stainless steel implant. , 1988, Orthopedics.

[13]  R. H. Culver Mechanisms, tolerances and responses obtained under dynamic superior-inferior head impact, a pilot study. Final report , 1978 .

[14]  James H. McElhaney,et al.  Cervical Spine Compression Responses , 1983 .

[15]  Chieh-Tsai Wu,et al.  Use of a polymethylmethacrylate cervical cage in the treatment of single-level cervical disc disease. , 2005, Journal of neurosurgery. Spine.