1. Bony ingrowth potential of 3D-printed porous titanium alloy: a direct comparison of interbody cage materials in an in vivo ovine lumbar fusion model
- Author
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McGilvray, Kirk C, Easley, Jeremiah, Seim, Howard B, Regan, Daniel, Berven, Sigurd H, Hsu, Wellington K, Mroz, Thomas E, and Puttlitz, Christian M
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Bioengineering ,Alloys ,Animals ,Benzophenones ,Biomechanical Phenomena ,Bone-Anchored Prosthesis ,Ketones ,Lumbar Vertebrae ,Osseointegration ,Polyethylene Glycols ,Polymers ,Printing ,Three-Dimensional ,Prosthesis Design ,Range of Motion ,Articular ,Sheep ,Spinal Fusion ,Titanium ,X-Ray Microtomography ,3D porous titanium ,Interbody cage ,Ovine ,PEEK ,Spine ,Spine fusion ,Neurosciences ,Orthopedics ,Clinical sciences ,Allied health and rehabilitation science - Abstract
Background contextThere is significant variability in the materials commonly used for interbody cages in spine surgery. It is theorized that three-dimensional (3D)-printed interbody cages using porous titanium material can provide more consistent bone ingrowth and biological fixation.PurposeThe purpose of this study was to provide an evidence-based approach to decision-making regarding interbody materials for spinal fusion.Study designA comparative animal study was performed.MethodsA skeletally mature ovine lumbar fusion model was used for this study. Interbody fusions were performed at L2-L3 and L4-L5 in 27 mature sheep using three different interbody cages (ie, polyetheretherketone [PEEK], plasma sprayed porous titanium-coated PEEK [PSP], and 3D-printed porous titanium alloy cage [PTA]). Non-destructive kinematic testing was performed in the three primary directions of motion. The specimens were then analyzed using micro-computed tomography (µ-CT); quantitative measures of the bony fusion were performed. Histomorphometric analyses were also performed in the sagittal plane through the interbody device. Outcome parameters were compared between cage designs and time points.ResultsFlexion-extension range of motion (ROM) was statistically reduced for the PTA group compared with the PEEK cages at 16 weeks (p-value=.02). Only the PTA cages demonstrated a statistically significant decrease in ROM and increase in stiffness across all three loading directions between the 8-week and 16-week sacrifice time points (p-value≤.01). Micro-CT data demonstrated significantly greater total bone volume within the graft window for the PTA cages at both 8 weeks and 16 weeks compared with the PEEK cages (p-value
- Published
- 2018