School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA, 15213, USA.
Eur Spine J. 2022 Oct;31(10):2547-2556. doi: 10.1007/s00586-022-07272-1. Epub 2022 Jun 10.
Interbody fusion is commonly utilized for arthrodesis and stability among patients undergoing spine surgery. Over the last few decades, interbody device materials, such as titanium and polyetheretherketone (PEEK), have been replacing traditional autografts and allografts for interbody fusion. As such, with the exponential growth of bioengineering, a large variety cage surface technologies exist. Different combinations of cage component materials and surface modifications have been created to optimize interbody constructs for surgical use. This review aims to provide a comprehensive overview of common surface technologies, their performance in the clinical setting, and recent modifications and material combinations.
We performed a comprehensive review of the literature on titanium and PEEK as medical devices between 1964 and 2021. We searched five major databases, resulting in 4974 records. Articles were screened for inclusion manually by two independent reviewers, resulting in 237 articles included for review.
Interbody devices have rapidly evolved over the last few decades. Biomaterial and biomechanical modifications have allowed for continued design optimization. While titanium has a high osseointegrative capacity, it also has a high elastic modulus and is radio-opaque. PEEK, on the other hand, has a lower elastic modulus and is radiolucent, though PEEK has poor osseointegrative capacity. Surface modifications, material development advancements, and hybrid material devices have been utilized in search of an optimal spinal implant which maximizes the advantages and minimizes the disadvantages of each interbody material.
在脊柱手术中，椎体间融合通常用于关节融合和稳定性。在过去的几十年中，椎体间融合器的材料（如钛和聚醚醚酮（PEEK））已经取代了传统的自体移植物和同种异体移植物。随着生物工程的指数级增长，存在大量的椎间笼表面技术。为了优化椎间融合器的手术应用，已经创造了不同组合的笼组件材料和表面改性。本综述旨在全面概述常见的表面技术、它们在临床环境中的性能以及最近的改性和材料组合。
我们对 1964 年至 2021 年间钛和 PEEK 作为医疗器械的文献进行了全面回顾。我们在五个主要数据库中进行了搜索，共产生了 4974 条记录。通过两名独立评审员手动筛选文章，最终有 237 篇文章被纳入审查。
在过去的几十年中，椎体间融合器发展迅速。生物材料和生物力学的改进使得设计不断优化。钛具有较高的骨整合能力，但弹性模量也较高且具有放射性不透明性。另一方面，PEEK 的弹性模量较低且具有放射性不透明性，尽管 PEEK 的骨整合能力较差。表面改性、材料开发进展和混合材料设备已经被用于寻找一种最佳的脊柱植入物，以最大限度地发挥每种椎间材料的优势并最小化其缺点。
