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Does nanoscale porous titanium coating increase lumbar spinal stiffness of an interbody fusion cage? An in vivo biomechanical analysis in an ovine model.
Gunzburg, Robert; Colloca, Christopher J; Jones, Claire F; Hall, David J; McAviney, Jeb; Callary, Stuart; Hegazy, Mostafa A; Szpalski, Marek; Freeman, Brian J C.
Afiliación
  • Gunzburg R; Department of Orthopaedic Surgery, Edith Cavell Clinic, Brussels, Belgium. Electronic address: robert@gunzburg.be.
  • Colloca CJ; International Spine Research Foundation, Chandler, AZ, USA.
  • Jones CF; Adelaide Centre for Spinal Research, SA Pathology, Adelaide, Australia; Centre for Orthopaedic and Trauma Research, University of Adelaide, Australia.
  • Hall DJ; Adelaide Centre for Spinal Research, SA Pathology, Adelaide, Australia; Department of Spinal Surgery, Royal Adelaide Hospital, Adelaide, Australia.
  • McAviney J; Sydney Scoliosis Clinic, Sydney, Australia.
  • Callary S; School of Mechanical Engineering, University of Adelaide, Australia.
  • Hegazy MA; Science Department, Southwest Minnesota State University, Marshall, MN, USA.
  • Szpalski M; Department of Orthopedics, Hôpitaux Iris Sud/IRIS South Teaching Hospitals, Brussels, Belgium.
  • Freeman BJC; Adelaide Centre for Spinal Research, SA Pathology, Adelaide, Australia; Centre for Orthopaedic and Trauma Research, University of Adelaide, Australia; Department of Spinal Surgery, Royal Adelaide Hospital, Adelaide, Australia.
Clin Biomech (Bristol, Avon) ; 67: 187-196, 2019 07.
Article en En | MEDLINE | ID: mdl-31176064
BACKGROUND: Quantitative objective measures to determine fusion achievement further enable the comparison of new technologies, such as interbody cage surface enhancement. Our aims were to compare in vivo biomechanical responses of ovine L4/5 lumbar motion segments with two cages: 1) Polyetheretherketone or 2) Polyetheretherketone with a nanosurfaced titanium porous scaffold from Nanovis, Inc. METHODS: Fourteen Merino sheep randomly received either 1) standard Polyetheretherketone cage or 2) Nanocoated Polyetheretherketone cage at L4/L5 with autologous bone graft. At baseline and one-year follow-up, dynamic spinal stiffness was quantified in vivo using a validated mechanical assessment at 2 Hz, 6 Hz, and 12 Hz. The dorsoventral secant stiffness (ky = force/displacement, N/mm) and L4-L5 accelerations were determined at each frequency. A repeated measures analysis of variance with Bonferonni correction was used to evaluate within and between group differences among the biomechanical variables. FINDINGS: Both implants increased spinal stiffness at 2 Hz (21 and 39%, respectively, p < .005), and at 6 Hz (12 and 27%, p < .0001). Significantly greater spinal stiffness was observed with Nanocoated Polyetheretherketone at one-year for both frequencies (p < .05). No significant differences were observed at 12 Hz within or between groups. L4-L5 dorsoventral accelerations were significantly decreased one year following cage placement only with Nanocoated Polyetheretherketone (p < .05) and greater reductions in acceleration were observed with Nanocoated Polyetheretherketone compared to standard Polyetheretherketone (p < .05). INTERPRETATION: Both cages increased spinal stiffness, yet, nanosurfaced cages resulted in greater spinal stiffness changes and decreases in L4-L5 accelerations. These findings may assist in clinical decision making and post-operative recovery strategies.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prótesis e Implantes / Fusión Vertebral / Titanio / Nanoestructuras / Vértebras Lumbares Tipo de estudio: Prognostic_studies Límite: Animals / Female / Humans Idioma: En Revista: Clin Biomech (Bristol, Avon) Asunto de la revista: ENGENHARIA BIOMEDICA / FISIOLOGIA Año: 2019 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prótesis e Implantes / Fusión Vertebral / Titanio / Nanoestructuras / Vértebras Lumbares Tipo de estudio: Prognostic_studies Límite: Animals / Female / Humans Idioma: En Revista: Clin Biomech (Bristol, Avon) Asunto de la revista: ENGENHARIA BIOMEDICA / FISIOLOGIA Año: 2019 Tipo del documento: Article Pais de publicación: Reino Unido