Wu Meng-Huang, Lee Ming-Hsueh, Wu Christopher, Tsai Pei-I, Hsu Wei-Bin, Huang Shin-I, Lin Tzu-Hung, Yang Kuo-Yi, Chen Chih-Yu, Chen Shih-Hao, Lee Ching-Yu, Huang Tsung-Jen, Tsau Fang-Hei, Li Yen-Yao
Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan.
Department of Orthopedics, Taipei Medical University Hospital, Taipei 110301, Taiwan.
Materials (Basel). 2022 May 20;15(10):3670. doi: 10.3390/ma15103670.
Autogenous bone grafts are the gold standard for interbody fusion implant materials; however, they have several disadvantages. Tantalum (Ta) and titanium (Ti) are ideal materials for interbody cages because of their biocompatibility, particularly when they are incorporated into a three-dimensional (3D) porous structure. We conducted an in vitro investigation of the cell attachment and osteogenic markers of self-fabricated uniform porous Ti (20%, 40%, 60%, and 80%), nonporous Ti, and porous Ta cages ( = 6) in each group. Cell attachment, osteogenic markers, and alkaline phosphatase (ALP) were measured. An in vivo study was performed using a pig-posterior-instrumented anterior interbody fusion model to compare the porous Ti (60%), nonporous Ti, and porous Ta interbody cages in 12 pigs. Implant migration and subsidence, determined using plain radiographs, were recorded before surgery, immediately after surgery, and at 1, 3, and 6 months after surgery. Harvested implants were assessed for bone ingrowth and attachment. Relative to the 20% and 40% porous Ti cages, the 60% and 80% cages achieved superior cellular migration into cage pores. Among the cages, osteogenic marker and ALP activity levels were the highest in the 60% porous Ti cage, osteocalcin expression was the highest in the nonporous Ti cage, and the 60% porous Ti cage exhibited the lowest subsidence. In conclusion, the designed porous Ti cage is biocompatible and suitable for lumbar interbody fusion surgery and exhibits faster fusion with less subsidence compared with porous Ta and nonporous Ti cages.
自体骨移植是椎间融合植入材料的金标准；然而，它们有几个缺点。钽（Ta）和钛（Ti）因其生物相容性而成为椎间融合器的理想材料，特别是当它们被制成三维（3D）多孔结构时。我们对每组自行制备的均匀多孔Ti（20%、40%、60%和80%）、无孔Ti和多孔Ta融合器（每组 = 6个）进行了细胞附着和成骨标志物的体外研究。测量了细胞附着、成骨标志物和碱性磷酸酶（ALP）。使用猪后路器械辅助前路椎间融合模型进行体内研究，以比较12头猪的多孔Ti（60%）、无孔Ti和多孔Ta椎间融合器。在手术前、手术后立即以及手术后1、3和6个月，使用X线平片确定植入物的移位和下沉情况，并进行记录。对取出的植入物进行骨长入和附着情况评估。相对于20%和40%的多孔Ti融合器，60%和80%的融合器实现了更好的细胞向融合器孔隙内迁移。在所有融合器中，60%多孔Ti融合器的成骨标志物和ALP活性水平最高，无孔Ti融合器的骨钙素表达最高，60%多孔Ti融合器的下沉最低。总之，所设计的多孔Ti融合器具有生物相容性，适用于腰椎椎间融合手术，与多孔Ta和无孔Ti融合器相比，融合更快且下沉更少。
