Independent Unit of Tissue Engineering and Regenerative Medicine, Medical University of Lublin, Chodzki 1 Street, 20-093 Lublin, Poland.
ChM sp. z o.o., Lewickie 3b Street, 16-061 Juchnowiec Kościelny, Poland.
Int J Mol Sci. 2022 Apr 3;23(7):3985. doi: 10.3390/ijms23073985.
Intervertebral cages made of Ti6Al4V alloy show excellent osteoconductivity, but also higher stiffness, compared to commonly used polyether-ether-ketone (PEEK) materials, that may lead to a stress-shielding effect and implant subsidence. In this study, a metallic intervertebral fusion cage, with improved mechanical behavior, was manufactured by the introduction of a three-dimensional (3D) mesh structure to Ti6Al4V material, using an additive manufacturing method. Then, the mechanical and biological properties of the following were compared: (1) PEEK, with a solid structure, (2) 3D-printed Ti6Al4V, with a solid structure, and (3) 3D-printed Ti6Al4V, with a mesh structure. A load-induced subsidence test demonstrated that the 3D-printed mesh Ti6Al4V cage had significantly lower tendency (by 15%) to subside compared to the PEEK implant. Biological assessment of the samples proved that all tested materials were biocompatible. However, both titanium samples (solid and mesh) were characterized by significantly higher bioactivity, osteoconductivity, and mineralization ability, compared to PEEK. Moreover, osteoblasts revealed stronger adhesion to the surface of the Ti6Al4V samples compared to PEEK material. Thus, it was clearly shown that the 3D-printed mesh Ti6Al4V cage possesses all the features for optimal spinal implant, since it carries low risk of implant subsidence and provides good osseointegration at the bone-implant interface.
钛 6 铝 4 钒（Ti6Al4V）合金椎间融合 cage 具有优异的骨诱导性，但与常用的聚醚醚酮（PEEK）材料相比刚度也更高，这可能导致应力遮挡效应和植入物下沉。在这项研究中，通过在 Ti6Al4V 材料中引入 3D 网格结构，采用增材制造方法制造了一种具有改善机械性能的金属椎间融合 cage。然后，对以下三种材料的机械和生物学性能进行了比较：（1）具有实心结构的 PEEK；（2）具有实心结构的 3D 打印 Ti6Al4V；（3）具有网格结构的 3D 打印 Ti6Al4V。负载诱导下沉试验表明，与 PEEK 植入物相比，3D 打印网格 Ti6Al4V cage 下沉的趋势明显更低（低 15%）。对样品的生物学评估证明所有测试材料均具有生物相容性。然而，与 PEEK 相比，钛的两种样品（实心和网格）均表现出更高的生物活性、骨诱导性和矿化能力。此外，与 PEEK 材料相比，成骨细胞在 Ti6Al4V 样品表面的黏附性更强。因此，很明显，3D 打印网格 Ti6Al4V cage 具有最佳脊柱植入物的所有特征，因为它具有较低的植入物下沉风险，并在骨-植入物界面提供良好的骨整合。
