Jia Cheng-Qi, Zhang Zhen, Cao Shi-Qi, Wang Tian-Jiao, Yu Hai-Chao, Wang Wen-Xiang, Guo Bo-Min, Qiu Xiong-Ying, You Yong-Gang, Hu Fan-Qi, Zhao Jun, Zhang Xue-Song
Medical School of Chinese PLA, Beijing, 100853, China.
Department of Orthopedics, Chinese PLA General Hospital, Beijing, 100853, China.
Bioact Mater. 2022 Nov 16;23:234-246. doi: 10.1016/j.bioactmat.2022.11.003. eCollection 2023 May.
OBJECTIVES: Spinal fusion is a widely employed treatment of patients with degenerative disc disease, in which a cage is used to replace the disc for spinal fusion. But it often fails for insufficient mechanical strength and poor osseointegration. Here, we designed a polyether-ether-ketone (PEEK)/tantalum (Ta) composite cage with a biomimetic gradient porous micro-structure, simultaneously enhancing mechanical properties and accelerating osseointegration in spinal fusion. MATERIALS AND METHODS: In the study, based on the mechanical performances of PEEK and osteogenic potential of Ta, and the three-dimensional (3D) structures of cuttlebone and vertebra, the cages were respectively 3D printed by pure PEEK, PEEK with 5 wt% Ta (PEEK/Ta-5), PEEK with 10 wt% Ta (PEEK/Ta-10) and PEEK with 15 wt% Ta (PEEK/Ta-15), then verified and in sheep cervical fusion model systematically. RESULTS: Vertebral Gyroid structure PEEK/Ta-15 cage exhibited superior mechanical properties than Cuttlebone-like structure PEEK/Ta-15 cage, closer to the cervical vertebra. Furthermore, PEEK/Ta-15 cage with higher Ta microparticles in PEEK provided a biomimetic gradient porous micro-structure with higher surface energy, guiding cell biological behavior, promoting new bone penetration, and accelerating osseointegration . CONCLUSION: In conclusion, the study designed a biomimetic gradient porous cage with a micro-structure for enhancing mechanical properties, accelerating osseointegration and forming an anatomical lock in the fusion segment through composites, mechanical efficiency, surface extension, and pores.
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