Walsh William Robert, Pelletier Matthew, Wills Dan, Wang Tian, Lloyd Max, Veldman Michael, Cordaro Nick, Brady Mark
Surgical and Orthopaedic Research Laboratories, UNSW Sydney, Sydney, Australia.
Invibio Ltd. Hillhouse International, Thornton-Cleveleys, FY5 4QD, United Kingdom.
N Am Spine Soc J. 2025 Jul 3;23:100756. doi: 10.1016/j.xnsj.2025.100756. eCollection 2025 Sep.
PEEK interbody cages are well established. 3D porous PEEK designs can now be produced with additive manufacturing. This study compared the in-vivo response of additive manufactured porous PEEK (3D PEEK) and titanium alloy (3D Ti) cages.
Interbody fusion was performed in 11 adult sheep at 2 levels (L2-3 and L4-5) using 3D PEEK and 3D Ti cages filled with autograft with posterior bilateral pedicle screw fixation. Fusions were evaluated at 8 and 16 weeks via manual palpation, microcomputed tomography (microCT), histology, and histomorphometry.
All animals recovered well following surgery with no adverse events. The radiolucent nature of PEEK allowed the fusions to be evaluated using radiographs and microCT. The 3D Ti cages however appeared solid rather than porous in the radiographs and presented artifacts in the microCT scans which precluded definitive determination of the fusions. Range of motion results improved with time for 3D PEEK and 3D Ti while no differences between designs were detected. Histology and histomorphometry confirmed 3D PEEK and 3D Ti supported fusion in this model using autograft.
Range of motion and histology results were similar for 3D PEEK and 3D Ti. Radiographs and microCT could be used to assess the fusions with 3D PEEK due to the radiolucent nature. 3D Ti appeared solid in the radiographs and had image artifact in microCT which precluded definitive evaluation of the fusions. 3D PEEK and 3D Ti cages both support interbody fusion in this preclinical model.
聚醚醚酮（PEEK）椎间融合器已得到广泛应用。现在可以通过增材制造生产三维多孔PEEK设计。本研究比较了增材制造的多孔PEEK（3D PEEK）和钛合金（3D Ti）融合器在体内的反应。
对11只成年绵羊的两个节段（L2-3和L4-5）进行椎间融合，使用填充自体骨的3D PEEK和3D Ti融合器，并进行双侧后路椎弓根螺钉固定。在8周和16周时通过手动触诊、微型计算机断层扫描（microCT）、组织学和组织形态计量学评估融合情况。
所有动物术后恢复良好，无不良事件。PEEK的射线可透性使得可以使用X线片和microCT评估融合情况。然而，3D Ti融合器在X线片中显得实心而非多孔，并且在microCT扫描中出现伪影，这妨碍了对融合情况的明确判定。3D PEEK和3D Ti的运动范围结果随时间改善，且未检测到设计之间的差异。组织学和组织形态计量学证实，在该使用自体骨的模型中，3D PEEK和3D Ti均支持融合。
3D PEEK和3D Ti的运动范围和组织学结果相似。由于PEEK的射线可透性，X线片和microCT可用于评估3D PEEK融合情况。3D Ti在X线片中显得实心，在microCT中有图像伪影，这妨碍了对融合情况的明确评估。在这个临床前模型中，3D PEEK和3D Ti融合器均支持椎间融合。
