Guyer Richard D, Abitbol Jean-Jacques, Ohnmeiss Donna D, Yao Chang
Texas Back Institute, Plano, TX.
California Spine Group, San Diego, CA.
Spine (Phila Pa 1976). 2016 Oct 1;41(19):E1146-E1150. doi: 10.1097/BRS.0000000000001672.
This was a biomechanical push-out testing study using a porcine model.
The purpose was to evaluate the strength of implant-bone interface of a porous titanium scaffold by comparing it to polyetheretherketone (PEEK) and allograft.
Osseointegration is important for achieving maximal stability of spinal fusion implants and it is desirable to achieve as quickly as possible. Common PEEK interbody fusion implants appear to have limited osseointegration potential because of the formation of fibrous tissue along the implant-bone interface. Porous, three-dimensional titanium materials may be an option to enhance osseointegration.
Using the skulls of two swine, in the region of the os frontale, 16 identical holes (4 mm diameter) were drilled to 10 mm depth in each skull. Porous titanium, PEEK, and allograft pins were press fit into the holes. After 5 weeks, animals were euthanized and the skull sections with the implants were cut into sections with each pin centered within a section. Push-out testing was performed using an MTS machine with a push rate of 6 mm/min. Load-deformation curves were used to compute the extrinsic material properties of the bone samples. Maximum force (N) and shear strength (MPa) were extracted from the output to record the bonding strength between the implant and surrounding bone. When calculating shear strength, maximum force was normalized by the actual implant surface area in contact with surrounding bone.
Mean push-out shear strength was significantly greater in the porous titanium scaffold group than in the PEEK or allograft groups (10.2 vs. 1.5 vs. 3.1 MPa, respectively; P < 0.05).
The push-out strength was significantly greater for the implants with porous titanium coating compared with the PEEK or allograft. These results suggest that the material has promise for facilitating osseointegration for implants, including interbody devices for spinal fusion.
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这是一项使用猪模型的生物力学推出测试研究。
通过将多孔钛支架的种植体-骨界面强度与聚醚醚酮（PEEK）和同种异体移植物进行比较，来评估其强度。
骨整合对于实现脊柱融合植入物的最大稳定性很重要，并且希望尽快实现。常见的PEEK椎间融合植入物由于在植入物-骨界面形成纤维组织，其骨整合潜力似乎有限。多孔三维钛材料可能是增强骨整合的一种选择。
使用两头猪的颅骨，在额骨区域，在每个颅骨上钻16个相同的孔（直径4毫米），深度为10毫米。将多孔钛、PEEK和同种异体移植销压配合到孔中。5周后，对动物实施安乐死，并将带有植入物的颅骨切片切成每个销位于切片中心的切片。使用MTS机器以6毫米/分钟的推出速率进行推出测试。载荷-变形曲线用于计算骨样本的外在材料特性。从输出中提取最大力（N）和剪切强度（MPa）以记录植入物与周围骨之间的结合强度。计算剪切强度时，最大力通过与周围骨接触的实际植入物表面积进行归一化。
多孔钛支架组的平均推出剪切强度显著高于PEEK或同种异体移植组（分别为10.2 vs. 1.5 vs. 3.1 MPa；P<0.05）。
与PEEK或同种异体移植相比，具有多孔钛涂层的植入物的推出强度显著更高。这些结果表明该材料有望促进植入物的骨整合，包括用于脊柱融合的椎间装置。
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