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Review
. 2020 Jun 23:26:29-41.
doi: 10.1016/j.jare.2020.06.017. eCollection 2020 Nov.

Meta-analyses comparing spine simulators with cadavers and finite element models by analysing range-of-motion data before and after lumbar total disc replacement

Tobias Bohn  1   2 , Susanne A J Lang  1 , Stephanie Roll  3 , Helene Schrader  1 , Matthias Pumberger  4 , Karin Büttner-Janz  1   5
Affiliations
Review

Meta-analyses comparing spine simulators with cadavers and finite element models by analysing range-of-motion data before and after lumbar total disc replacement

Tobias Bohn et al. J Adv Res. .

Abstract

Background: Range-of-motion (ROM) data generated by the in vitro test methods of spine simulators with cadavers (SSCs) and finite element models (FEMs) are used alternatively and complementarily for in vitro evaluations.

Aim of review: Our purpose is to compare exemplary segmental ROM data from SSCs and FEMs before and after ball-and-socket total disc replacement (bsTDR) to determine whether the two test methods provide the same data for the same evaluation subjects.

Key scientific concepts of review: We performed 70 meta-analyses (MAs) and 20 additional comparative analyses based on data from 21 SSC studies used for 39 MAs and 16 FEM studies used for 31 MAs. Only fifty-nine percent (n = 23/39) of SSC MAs show a restored ROM after bsTDR, whereas in FEM MAs, the ROM is restored in ninety percent (n = 28/31). Among the analyses comparing data from the same spinal segments, motion directions and bsTDR, SSC and FEM data are significantly different in ten percent (n = 2/20). According to our results, data generated by SSCs and FEMs cannot be used as alternative and complementary data without restriction. The quality of the evaluation methods itself as well as potential technical reasons for the discrepant results were not our evaluation target. Further SSC and FEM data should be compared using the same approach.

Keywords: In vitro test methods; Meta-analysis; Range of motion; Total disc replacement.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Exemplary forest plots of meta-analyses for the evaluation methods SSC spine simulator with cadaver and FEM finite element model. ROM range of motion (in degree). TDR total disc replacement, bsTDR ball-and-socket total disc replacement, AbsTDR all bsTDR (activL, CAD Charité artificial disc, InOrbit, Maverick, NewPro, Prodisc-L, prototype of an artificial disc in development, Slide-Disc, Triumph), intact ROM before TDR, decrease/increase in ROM ROM after TDR compared to intact.
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