Does nanoscale porous titanium coating increase lumbar spinal stiffness of an interbody fusion cage? An in vivo biomechanical analysis in an ovine model.
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 2â¯Hz, 6â¯Hz, and 12â¯Hz. The dorsoventral secant stiffness (kyâ¯=â¯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 2â¯Hz (21 and 39%, respectively, pâ¯<â¯.005), and at 6â¯Hz (12 and 27%, pâ¯<â¯.0001). Significantly greater spinal stiffness was observed with Nanocoated Polyetheretherketone at one-year for both frequencies (pâ¯<â¯.05). No significant differences were observed at 12â¯Hz within or between groups. L4-L5 dorsoventral accelerations were significantly decreased one year following cage placement only with Nanocoated Polyetheretherketone (pâ¯<â¯.05) and greater reductions in acceleration were observed with Nanocoated Polyetheretherketone compared to standard Polyetheretherketone (pâ¯<â¯.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.
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