Bioabsorbable self-retaining PLA/nano-sized β-TCP cervical spine interbody fusion cage in goat models: an in vivo study
Authors Cao L, Chen Q, Jiang LB, Yin XF, Bian C, Wang HR, Ma YQ, Li XQ, Li XL, Dong J
Received 9 January 2017
Accepted for publication 2 May 2017
Published 3 October 2017 Volume 2017:12 Pages 7197—7205
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Lei Yang
Lu Cao,1,* Qian Chen,1,* Li-Bo Jiang,1,* Xiao-Fan Yin,1,2 Chong Bian,1 Hui-Ren Wang,1 Yi-Qun Ma,1 Xiang-Qian Li,1 Xi-Lei Li,1 Jian Dong1
1Department of Orthopaedic Surgery, Zhongshan Hospital, 2Department of Orthopaedic Surgery, Minhang Hospital, Fudan University, Shanghai, China
*These authors contributed equally to this work
Study design: This is an experimental animal study.
Objective: The objective of this study was to compare an anterior cervical discectomy and interbody fusion of a novel polylactide/nano-sized β-tricalcium phosphate (PLA/nβ-TCP) bioabsorbable self-retaining cervical fusion cage (BCFC) with an autologous bone graft and polyetheretherketone (PEEK) cages.
Background: Although PLA cervical cages have potential advantages compared with traditional materials, they are not currently routinely used in spine surgery because of undesirable effects such as the lack of osteoconductivity and osteolysis around the implant. This study involved the manufacturing of a bioabsorbable cage from PLA/nβ-TCP that was then used as a device for anterior cervical discectomy and fusion (ACDF) on a goat cervical spine fusion model.
Materials and methods: Eighteen goats underwent C3/C4 discectomy and were randomly divided into three groups based on the following methods: Group A (n=6), an autologous bone graft; Group B (n=6), PEEK cage filled with an autologous graft; and Group C (n=6), BCFC filled with an autologous iliac bone. Radiography was performed preoperatively and postoperatively and at 1, 4, 8, and 12 weeks after the operation. Disc space height (DSH) was measured at the same time. After 12 weeks, the fused segments were harvested and evaluated with functional radiographic views, biomechanical testing, and histological analyses.
Results: Over a 12-week period, the BCFC and PEEK cage groups exhibited significantly higher DSH values than the bone graft group. Additionally, the BCFC group yielded a significantly lower range of motion in axial rotation than both the autologous bone graft and PEEK cage groups. A histologic evaluation revealed an increased intervertebral bone volume/total volume ratio and better interbody fusion in the BCFC group than in the other groups.
Conclusion: The BCFC device exhibited better results than the autologous bone graft and PEEK cages in single-level ACDF models in vivo. This device may be a potential alternative to the current PEEK cages.
Keywords: goat, cervical spine cages, bioabsorbable, PLA, β-TCP, self-retaining
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