Measuring compressive loads on a 'smart' lumbar interbody fusion cage: Proof of concept.

Ramakrishna, VAS; Chamoli, U; Mukhopadhyay, SC; Diwan, AD; Prusty, BG

Measuring compressive loads on a 'smart' lumbar interbody fusion cage: Proof of concept.

Ramakrishna, VAS Chamoli, U

Mukhopadhyay, SC Diwan, AD Prusty, BG

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Publisher:: ELSEVIER SCI LTD
Publication Type:: Journal Article
Citation:: J Biomech, 2023, 147, pp. 111440
Issue Date:: 2023-01

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Field	Value	Language
dc.contributor.author	Ramakrishna, VAS
dc.contributor.author	Chamoli, U https://orcid.org/0000-0002-8396-5814
dc.contributor.author	Mukhopadhyay, SC
dc.contributor.author	Diwan, AD
dc.contributor.author	Prusty, BG
dc.date.accessioned	2024-05-06T00:40:03Z
dc.date.available	2023-01-06
dc.date.available	2024-05-06T00:40:03Z
dc.date.issued	2023-01
dc.identifier.citation	J Biomech, 2023, 147, pp. 111440
dc.identifier.issn	0021-9290
dc.identifier.issn	1873-2380
dc.identifier.uri	http://hdl.handle.net/10453/178667
dc.description.abstract	There are several complications associated with lumbar interbody fusion surgery however, pseudarthrosis (non-union) presents a multifaceted challenge in the postoperative management of the patient. Rates of pseudarthrosis range from 3 to 20 % in patients with healthy bone and 20 to 30 % in patients with osteoporosis. The current methods in post-operative follow-up - radiographs and CT, have high false positive rates and poor agreement between them. The aim of this study was to develop and test a proof-of-concept load-sensing interbody cage that may be used to monitor fusion progression. Piezoresistive pressure sensors were calibrated and embedded within a polyether ether ketone (PEEK) interbody cage. Silicone and poly (methyl methacrylate) (PMMA) were inserted in the graft regions to simulate early and solid fusion. The load-sensing cage was subjected to distributed and eccentric compressive loads up to 900 N between synthetic lumbar vertebral bodies. Under maximum load, the anterior sensors recorded a 56-58 % reduction in pressure in the full fusion state compared to early fusion. Lateral regions measured a 36-37 % stress reduction while the central location reduced by 45 %. The two graft states were distinguishable by sensor-recorded pressure at lower loads. The sensors more effectively detected left and right eccentric loads compared to anterior and posterior. Further, the load-sensing cage was able to detect changes in endplate stiffness. The proof-of-concept 'smart' cage could detect differences in fusion state, endplate stiffness, and loading conditions in this in vitro experimental setup.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER SCI LTD
dc.relation.ispartof	J Biomech
dc.relation.isbasedon	10.1016/j.jbiomech.2023.111440
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	0903 Biomedical Engineering, 0913 Mechanical Engineering, 1106 Human Movement and Sports Sciences
dc.subject.classification	Biomedical Engineering
dc.subject.classification	4003 Biomedical engineering
dc.subject.classification	4207 Sports science and exercise
dc.subject.mesh	Humans
dc.subject.mesh	Pseudarthrosis
dc.subject.mesh	Spinal Fusion
dc.subject.mesh	Cadaver
dc.subject.mesh	Lumbar Vertebrae
dc.subject.mesh	Polyethylene Glycols
dc.subject.mesh	Lumbar Vertebrae
dc.subject.mesh	Humans
dc.subject.mesh	Pseudarthrosis
dc.subject.mesh	Cadaver
dc.subject.mesh	Polyethylene Glycols
dc.subject.mesh	Spinal Fusion
dc.subject.mesh	Humans
dc.subject.mesh	Pseudarthrosis
dc.subject.mesh	Spinal Fusion
dc.subject.mesh	Cadaver
dc.subject.mesh	Lumbar Vertebrae
dc.subject.mesh	Polyethylene Glycols
dc.title	Measuring compressive loads on a 'smart' lumbar interbody fusion cage: Proof of concept.
dc.type	Journal Article
utslib.citation.volume	147
utslib.location.activity	United States
utslib.for	0903 Biomedical Engineering
utslib.for	0913 Mechanical Engineering
utslib.for	1106 Human Movement and Sports Sciences
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
utslib.copyright.status	open_access	*
dc.date.updated	2024-05-06T00:40:02Z
pubs.publication-status	Published
pubs.volume	147

Abstract:

There are several complications associated with lumbar interbody fusion surgery however, pseudarthrosis (non-union) presents a multifaceted challenge in the postoperative management of the patient. Rates of pseudarthrosis range from 3 to 20 % in patients with healthy bone and 20 to 30 % in patients with osteoporosis. The current methods in post-operative follow-up - radiographs and CT, have high false positive rates and poor agreement between them. The aim of this study was to develop and test a proof-of-concept load-sensing interbody cage that may be used to monitor fusion progression. Piezoresistive pressure sensors were calibrated and embedded within a polyether ether ketone (PEEK) interbody cage. Silicone and poly (methyl methacrylate) (PMMA) were inserted in the graft regions to simulate early and solid fusion. The load-sensing cage was subjected to distributed and eccentric compressive loads up to 900 N between synthetic lumbar vertebral bodies. Under maximum load, the anterior sensors recorded a 56-58 % reduction in pressure in the full fusion state compared to early fusion. Lateral regions measured a 36-37 % stress reduction while the central location reduced by 45 %. The two graft states were distinguishable by sensor-recorded pressure at lower loads. The sensors more effectively detected left and right eccentric loads compared to anterior and posterior. Further, the load-sensing cage was able to detect changes in endplate stiffness. The proof-of-concept 'smart' cage could detect differences in fusion state, endplate stiffness, and loading conditions in this in vitro experimental setup.

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http://hdl.handle.net/10453/178667