Biomechanical and Histologic analysis of artificial intervertebral disc replacement under dynamic in vivo environment.

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The objective of this study was to analyze the segmental biomechanics and interface histology of the total artificial intervertebral disc replacement in an animal model. A new artificial intervertebral disc consisted of a triaxial three-dimensional fabric woven by an ultrahigh molecular weight polyethylene fiber, and spray-coated bioactive ceramics on the disc surface. From 1996, the basic structure of artificial disc has been designed. It represented the tensile-compressive, torsional, viscoelastic, and fatigue properties similar to the normal lumbar disc. The total intervertebral disc replacement was conducted in a sheep model with the observation periods up to 15 months. Using a bioabsorbable internal fixation device, the initial fixation of artificial disc was securely achieved and three-dimensional segmental mobility was preserved at 15 months. Histologically, the vertebral trabeculae showed a direct contact to artificial disc, inserting into the fabric inside. The interface strength examined by detaching tests exceeded the ones of ceramic interface, which were previously reported. The total artificial disc replacement using bioabsorbable spinal fixation has a potential for the future spinal reconstruction.