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Cyclical Loading to Evaluate the Bone Implant Interface
The goal of in vitro cyclical loading studies in spine biomechanics is to provide empirical data related to the long-term efficacy of spinal implants. Ultimately, these studies are used to determine if an implant has the ability to provide biomechanical stability over extended periods of time until arthrodesis achieves. In these studies, the bone implant interface should be gradually stressed according to physiological loading patterns to determine the rate at which the interfacial strength between the bone and implant degrades. When designed properly, these studies may able be used to determine the ultimate failure load of the bone implant interface. While study design is always an important aspect in benchtop research, the repetitive nature of in vitro cyclical loading studies exacerbates the effects of study design and emphasizes the importance of rigorous planning based on a strong understanding of the boundary conditions. This chapter is therefore focused on the most important aspects of study design surrounding in vitro spine biomechanics including specimen preparation, loading rate, loading magnitude, loading modality, outcome measures, and failure criteria and how they influence the results of these studies.