Biomechanical Comparison of Locking Compression Plate versus Positive Profile Pins and Polymethylmethacrylate for Stabilization of the Canine Lumbar Vertebrae.

ABSTRACT

OBJECTIVE: To compare the stiffness, angular deformation, and mode of failure of lumbar vertebral column constructs stabilized with bilateral pins and polymethylmethacrylate (Pin-PMMA) or with a unilateral (left) locking compression plate (LCP) with monocortical screws. STUDY DESIGN: Ex vivo biomechanical, non-randomized. SAMPLES Cadaveric canine thoracolumbar specimens (n=16). METHODS: Thoracolumbar (T13-L3) vertebral specimens had the L1-L2 vertebral motion unit stabilized with either Pin-PMMA or LCP. Stiffness in flexion, extension, and right and left lateral bending after nondestructive testing were compared between intact (pretreated) specimens and Pin-PMMA, and LCP constructs. The Pin-PMMA and LCP constructs were then tested to failure in flexion and left lateral bending. RESULTS: Both the Pin-PMMA and LCP constructs had reduced range of motion at the stabilized L1-L2 vertebral motion unit compared to intact specimens. The Pin-PMMA constructs had less range of motion for the flexion elastic zone than LCP constructs. The Pin-PMMA constructs were stiffer than intact specimens in flexion, extension, and lateral bending, and stiffer than LCP constructs in flexion and left lateral bending. The Pin-PMMA constructs had less angular deformation at construct yield and lower residual deformation at L1-L2 than LCP constructs after destructive testing to failure in flexion. The Pin-PMMA constructs were stiffer, stronger, and had less deformation at yield than LCP constructs after destructive testing to failure in lateral bending. Most constructs failed distant to the implant and fixation site. CONCLUSIONS: Pin-PMMA constructs had greater lumbar vertebral stiffness and reduced ROM than LCP constructs; however, both Pin-PMMA and LCP constructs were stronger than intact specimens.