Braided tubular superelastic cables provide improved spinal stability compared to multifilament sublaminar cables

This study investigates the use of braided tubular superelastic cables, previously used for sternum closure following sternotomy, as sublaminar fixation method. It compares the biomechanical performance of spinal instrumentation fixation systems with regular sublaminar cables and proprietary superelastic cables. A hybrid experimental protocol was applied to six porcine L1–L4 spinal segments to compare multifilament sublaminar cables (Atlas, Medtronic Sofamor Danek, Memphis, TN) with proprietary superelastic cables. First, intact total range of motion was determined for all specimens using pure moment loading. Second, pure moments were imposed to the instrumented specimens until these intact total ranges of motion were reproduced. Compared to the intact specimens, the use of superelastic cables resulted in stiffer instrumented specimens than the use of multifilament cables for all the loading modes except axial torsion. Consequently, the superelastic cables limited the instrumented segments mobility more than the multifilament cables. Spinal instrumentation fixation systems using superelastic cables could be a good alternative to conventional sublaminar cables as it maintains a constant stabilization of the spine during loading.