An additively manufactured model for preclinical testing of cervical devices

Jenna M Wahbeh; Erika Hookasian; John Lama; Labiba Alam; Sang-Hyun Park; Sophia N Sangiorgio; Edward Ebramzadeh

doi:10.1002/jsp2.1285

An additively manufactured model for preclinical testing of cervical devices

JOR Spine. 2023 Oct 6;7(1):e1285. doi: 10.1002/jsp2.1285. eCollection 2024 Mar.

Authors

Jenna M Wahbeh^{1

2}, Erika Hookasian^{1

2}, John Lama^{1

2}, Labiba Alam^{1

2}, Sang-Hyun Park^{1

3}, Sophia N Sangiorgio^{1

2

3}, Edward Ebramzadeh^{1

3}

Affiliations

¹ The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center Luskin Orthopaedic Institute for Children Los Angeles California USA.
² Department of Bioengineering UCLA Los Angeles California USA.
³ Department of Orthopaedic Surgery UCLA Los Angeles California USA.

Abstract

Purpose: Composite models have become commonplace for the assessment of fixation and stability of total joint replacements; however, there are no comparable models for the cervical spine to evaluate fixation. The goal of this study was to create the framework for a tunable non-homogeneous model of cervical vertebral body by identifying the relationships between strength, in-fill density, and lattice structure and creating a final architectural framework for specific strengths to be applied to the model.

Methods: The range of material properties for cervical spine were identified from literature. Using additive manufacturing software, rectangular prints with three lattice structures, gyroid, triangle, zig-zag, and a range of in-fill densities were 3D-printed. The compressive and shear strengths for all combinations were calculated in the axial and coronal planes. Eleven unique vertebral regions were selected to represent the distribution of density. Each bone density was converted to strength and subsequently correlated to the lattice structure and in-fill density with the desired material properties. Finally, a complete cervical vertebra model was 3D-printed to ensure sufficient print quality.

Results: Materials testing identified a relationship between in-fill densities and strength for all lattice structures. The axial compressive strength of the gyroid specimens ranged from 1.5 MPa at 10% infill to 31.3 MPa at 100% infill and the triangle structure ranged from 2.7 MPa at 10% infill to 58.4 MPa at 100% infill. Based on these results, a cervical vertebra model was created utilizing cervical cancellous strength values and the corresponding in-fill density and lattice structure combination. This model was then printed with 11 different in-fill densities ranging from 33% gyroid to 84% triangle to ensure successful integration of the non-homogeneous in-fill densities and lattice structures.

Conclusions: The findings from this study introduced a framework for using additive manufacturing to create a tunable, customizable biomimetic model of a cervical vertebra.

Keywords: biomechanical testing; cervical disc replacement; cervical spine; composite model; preclinical model.