Guo Xiuwu, Xu Haocheng, Zhang Fan, Lu Feizhou
Department of Orthopedics, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
Ann Transl Med. 2020 Sep;8(17):1054. doi: 10.21037/atm-20-225.
Bioabsorbable Mg-based implants have been a focus of orthopedic researches due to their intrinsic advantages in orthopedics surgeries. This study aimed to investigate the performance of bioabsorbable high-purity magnesium (HP Mg, 99.98 wt.%) interbody cages in anterior cervical discectomy and fusion (ACDF) and to evaluate the degradation of HP Mg cages under an interbody microenvironment.
ACDF was performed at C2-3 and C4-5, and a HP Mg cage or autologous iliac bone was randomly implanted. At 3, 6, 12 and 24 weeks after surgery, the cervical specimens were harvested to evaluate the fusion status, degradation and biocompatibility by CT, micro-CT, histological examinations and blood tests.
There was no significant difference in the CT fusion score between cage group and autogenous ilium group at 3 and 6 weeks. At 12 and 24 weeks, the mean CT fusion score in the cage group was markedly lower than in the autogenous ilium group. CT and histological examinations showed bony junctions formed through the middle hole of the cage between upper and lower vertebral bodies in the cage group, but the total fusion area was less than 30%. The degradation rate of cages was relatively rapid within the first 3 weeks and thereafter became stable and slow gradually. The HP Mg cage had good biosecurity and biomechanical characteristics.
Implantation of Mg-based interbody cage achieves successful histological fusion, while the total fusion area needs to be improved. More studies are needed to improve the bone-cage interface.
可生物吸收的镁基植入物因其在骨科手术中的固有优势，一直是骨科研究的重点。本研究旨在探讨可生物吸收的高纯度镁（HP Mg，99.98 wt.%）椎间融合器在前路颈椎间盘切除融合术（ACDF）中的性能，并评估HP Mg椎间融合器在椎间微环境下的降解情况。
在C2-3和C4-5节段进行ACDF手术，随机植入HP Mg椎间融合器或自体髂骨。术后3、6、12和24周，采集颈椎标本，通过CT、显微CT、组织学检查和血液检测评估融合状态、降解情况和生物相容性。
在术后3周和6周时，椎间融合器组和自体髂骨组的CT融合评分无显著差异。在12周和24周时，椎间融合器组的平均CT融合评分明显低于自体髂骨组。CT和组织学检查显示，椎间融合器组上下椎体间通过椎间融合器的中孔形成了骨连接，但总融合面积小于30%。椎间融合器在最初3周内降解速度相对较快，此后逐渐稳定并减缓。HP Mg椎间融合器具有良好的生物安全性和生物力学特性。
植入镁基椎间融合器可实现组织学融合，但总融合面积有待提高。需要更多研究来改善骨-融合器界面。
