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多孔钛-6 铝-4 钒笼在羊的椎体融合中比聚醚醚酮笼具有更好的骨整合和更小的微动。

Porous titanium-6 aluminum-4 vanadium cage has better osseointegration and less micromotion than a poly-ether-ether-ketone cage in sheep vertebral fusion.

机构信息

Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.

出版信息

Artif Organs. 2013 Dec;37(12):E191-201. doi: 10.1111/aor.12153. Epub 2013 Oct 22.

Abstract

Interbody fusion cages made of poly-ether-ether-ketone (PEEK) have been widely used in clinics for spinal disorders treatment; however, they do not integrate well with surrounding bone tissue. Ti-6Al-4V (Ti) has demonstrated greater osteoconductivity than PEEK, but the traditional Ti cage is generally limited by its much greater elastic modulus (110 GPa) than natural bone (0.05-30 GPa). In this study, we developed a porous Ti cage using electron beam melting (EBM) technique to reduce its elastic modulus and compared its spinal fusion efficacy with a PEEK cage in a preclinical sheep anterior cervical fusion model. A porous Ti cage possesses a fully interconnected porous structure (porosity: 68 ± 5.3%; pore size: 710 ± 42 μm) and a similar Young's modulus as natural bone (2.5 ± 0.2 GPa). When implanted in vivo, the porous Ti cage promoted fast bone ingrowth, achieving similar bone volume fraction at 6 months as the PEEK cage without autograft transplantation. Moreover, it promoted better osteointegration with higher degree (2-10x) of bone-material binding, demonstrated by histomorphometrical analysis, and significantly higher mechanical stability (P < 0.01), shown by biomechanical testing. The porous Ti cage fabricated by EBM could achieve fast bone ingrowth. In addition, it had better osseointegration and superior mechanical stability than the conventional PEEK cage, demonstrating great potential for clinical application.

摘要

聚醚醚酮(PEEK)椎间融合器已广泛应用于脊柱疾病的临床治疗中;然而,它们与周围骨组织的整合效果并不理想。钛-6 铝-4 钒(Ti)的骨诱导性优于 PEEK,但传统的 Ti 笼通常受到其弹性模量(110GPa)远高于天然骨(0.05-30GPa)的限制。在这项研究中,我们使用电子束熔化(EBM)技术开发了一种多孔 Ti 笼,以降低其弹性模量,并在临床前绵羊前路颈椎融合模型中比较了其与 PEEK 笼的脊柱融合效果。多孔 Ti 笼具有完全连通的多孔结构(孔隙率:68±5.3%;孔径:710±42μm)和与天然骨相似的杨氏模量(2.5±0.2GPa)。当植入体内时,多孔 Ti 笼促进了快速的骨长入,在 6 个月时达到与无自体移植物移植的 PEEK 笼相似的骨体积分数。此外,通过组织形态计量学分析,它促进了更好的骨整合,骨-材料结合程度更高(2-10 倍),生物力学测试也显示出更高的机械稳定性(P<0.01)。EBM 制造的多孔 Ti 笼可以实现快速的骨长入。此外,它与传统的 PEEK 笼相比具有更好的骨整合和更高的机械稳定性,显示出在临床应用中的巨大潜力。

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