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A preclinical large animal study on a novel intervertebral fusion cage covered with high porosity titanium sheets with a triple pore structure used for spinal fusion

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Abstract

Purpose

To evaluate the osteoconductivity and the bonding strength of the newly developed interbody cage covered with the porous titanium sheet (porous Ti cage) to vertebral bodies in a sheep model.

Methods

Twelve sheep underwent anterior lumbar interbody fusion at L2–3 and L4–5 using either the new porous Ti cages (Group-P) or conventional Ti cages with autogenous iliac bone (Group-C). The animals were euthanized at 2 or 4 months postoperatively and subjected to radiological, biomechanical, and histological examinations.

Results

Computed tomography analyses showed that the ratio of bone contact area in Group-P was significantly increased at 4 months compared with that at 2 months (p = 0.01). Although the ratio of bone contact area in Group-C was significantly higher than Group-P at 2 months (p < 0.001), there was no statistically significant difference between the two groups at 4 months. Biomechanical test showed that there was no significant difference in bonding strength between the two groups at either 2 or 4 months. Histological analyses revealed that the bone apposition ratio increased significantly with time in Group-P (p < 0.001). Although Group-C showed significantly higher bone apposition ratio than Group-P at 2 months (p = 0.001), there was no statistical difference between the two groups at 4 months.

Conclusions

There was bone ingrowth into the porous Ti sheet, and bonding capacity of the porous Ti cage to the host bone increased with time. However, the speed of union to the bone with a porous Ti cage was marginally lower than a conventional cage along with an autogenous bone graft. Although it needs further experiment with a larger sample size, the results of the current study suggested that this material could achieve interbody fusion without the need for bone grafts.

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References

  1. Zhou ZJ, Zhao FD, Fang XQ, Zhao X, Fan SW (2011) Meta-analysis of instrumented posterior interbody fusion versus instrumented posterolateral fusion in the lumbar spine. J Neurosurg Spine 15(3):295–310

    Article  PubMed  Google Scholar 

  2. Rihn JA, Patel R, Makda J, Hong J, Anderson DG, Vaccaro AR, Hilibrand AS, Albert TJ (2009) Complications associated with single-level transforaminal lumbar interbody fusion. Spine J 9(8):623–629

    Article  PubMed  Google Scholar 

  3. Rihn JA, Kirkpatrick K, Albert TJ (2010) Graft options in posterolateral and posterior interbody lumbar fusion. Spine (Phila Pa 1976) 35(17):1629–1639

  4. Abbushi A, Cabraja M, Thomale UW, Woiciechowsky C, Kroppenstedt SN (2009) The influence of cage positioning and cage type on cage migration and fusion rates in patients with monosegmental posterior lumbar interbody fusion and posterior fixation. Eur Spine J 18(11):1621–1628

    Article  PubMed Central  PubMed  Google Scholar 

  5. Alvarez K, Nakajima H (2009) Metallic scaffolds for bone regeneration. Materials 2(3):790–832

    Article  CAS  Google Scholar 

  6. Ryan G, Pandit A, Apatsidis DP (2006) Fabrication methods of porous metals for use in orthopaedic applications. Biomaterials 27(13):2651–2670

    Article  CAS  PubMed  Google Scholar 

  7. Hanzlik JA, Day JS (2013) Bone ingrowth in well-fixed retrieved porous tantalum implants. J Arthroplasty 28(6):922–927

    Article  PubMed Central  PubMed  Google Scholar 

  8. Murata M, Akazawa T, Tazaki J, Ito K, Sasaki T, Yamamoto M, Tabata Y, Arisue M (2007) Blood permeability of a novel ceramic scaffold for bone morphogenetic protein-2. J Biomed Mater Res B Appl Biomater 81(2):469–475

    Article  CAS  PubMed  Google Scholar 

  9. Akazawa T, Murata M, Sasaki T, Tazaki J, Kobayashi M, Kanno T, Nakamura K, Arisue M (2006) Biodegradation and bioabsorption innovation of the functionally graded bovine bone-originated apatite with blood permeability. J Biomed Mater Res A 76(1):44–51

    Article  PubMed  Google Scholar 

  10. Sakamoto M, Nakasu M, Matsumoto T, Okihana H (2007) Development of superporous hydroxyapatites and their examination with a culture of primary rat osteoblasts. J Biomed Mater Res A 82(1):238–242

    Article  PubMed  Google Scholar 

  11. Sakamoto M, Matsumoto T (2012) Development and evaluation of superporous ceramics bone tissue scaffold materials with triple pore structure A) hydroxyapatite, B) Beta-Tricalcium phosphate. Haim Tal Bone Regeneration Croatia: In Tech:301–320

  12. Kato K, Yamamoto A, Ochiai S, Daigo Y, Isobe T, Matano S, Omori K (2012) Cell proliferation, corrosion resistance and mechanical properties of novel titanium foam with sheet shpase. Mater Trans 53(4):724–732

    Article  CAS  Google Scholar 

  13. Kato K, Ochiai S, Yamamoto A, Daigo Y, Honma K, Matano S, Omori K (2013) Novel multilayer Ti foam with cortical bone strength and cytocompatibility. Acta Biomater 9(3):5802–5809

    Article  CAS  PubMed  Google Scholar 

  14. Ito M, Kotani Y, Hojo Y, Abumi K, Kadosawa T, Minami A (2007) Evaluation of hydroxyapatite ceramic vertebral spacers with different porosities and their binding capability to the vertebral body: an experimental study in sheep. J Neurosurg Spine 6(5):431–437

    Article  PubMed  Google Scholar 

  15. Lee JH, Jeon DW, Lee SJ, Chang BS, Lee CK (2010) Fusion rates and subsidence of morselized local bone grafted in titanium cages in posterior lumbar interbody fusion using quantitative three-dimensional computed tomography scans. Spine (Phila Pa 1976) 35(15):1460–1465

  16. Motomiya M, Ito M, Takahata M, Kadoya K, Irie K, Abumi K, Minami A (2007) Effect of Hydroxyapatite porous characteristics on healing outcomes in rabbit posterolateral spinal fusion model. Eur Spine J 16(12):2215–2224

    Article  PubMed Central  PubMed  Google Scholar 

  17. Assad M, Jarzem P, Leroux MA, Coillard C, Chernyshov AV, Charette S, Rivard CH (2003) Porous titanium-nickel for intervertebral fusion in a sheep model: part 1. Histomorphometric and radiological analysis. J Biomed Mater Res B Appl Biomater 64(2):107–120

    Article  PubMed  Google Scholar 

  18. Takemoto M, Fujibayashi S, Neo M, So K, Akiyama N, Matsushita T, Kokubo T, Nakamura T (2007) A porous bioactive titanium implant for spinal interbody fusion: an experimental study using a canine model. J Neurosurg Spine 7(4):435–443

    Article  PubMed  Google Scholar 

  19. Zou X, Li H, Bünger M, Egund N, Lind M, Bünger C (2004) Bone ingrowth characteristics of porous tantalum and carbon fiber interbody devices: an experimental study in pigs. Spine J 4(1):99–105

    Article  PubMed  Google Scholar 

  20. Zou X, Li H, Teng X, Xue Q, Egund N, Lind M, Bünger C (2005) Pedicle screw fixation enhances anterior lumbar interbody fusion with porous tantalum cages: an experimental study in pigs. Spine (Phila Pa 1976) 30(14):E392–E399

  21. Long M, Rack HJ (1998) Titanium alloys in total joint replacement—a materials science perspective. Biomaterials 19(18):1621–1639

    Article  CAS  PubMed  Google Scholar 

  22. Colnot C (2011) Cell sources for bone tissue engineering: insights from basic science. Tissue Eng Part B Rev 17(6):449–457

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Wilke HJ, Kettler A, Claes LE (1997) Are sheep spines a valid biomechanical model for human spines? Spine (Phila Pa 1976) 22(20):2365–2374

  24. Hojo Y, Kotani Y, Ito M, Abumi K, Kadosawa T, Shikinami Y, Minami A (2005) A biomechanical and histological evaluation of a bioresorbable lumbar interbody fusion cage. Biomaterials 26(15):2643–2651

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We thank Toshio Matsumoto, B.S. and Takehiko Nakajima, B.S., HOYA Pentax Co., for their technical support and providing Ti porous materials and downsized intervertebral spacers for the animals. Furthermore, we thank Ken Nagahama, M.D., Ph.D. for his support in performing the surgery and to Fumio Sasazawa, M.D., Ph.D for capturing CT images. This study was supported by HOYA Pentax Co., Start-up Grant of Northern Advancement Center for Science & Technology, and Strategic Promotion of Innovative Research and Development, Japan Science and Technology Agency.

Conflict of interest

Manabu Ito has received research grants from HOYA-Pentax, Co., Robert-Reid, Inc and Century-Medical, Co., and is a board member of AOSpine Knowledge Forum. Toru Yamamoto has received endowments from Mizuho Ikakogyo, Co., Ltd. The other authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Graduate School of Medicine, Hokkaido University, North-15, West-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan

    Katsuhisa Yamada & Norimasa Iwasaki

  2. Department of Spine and Spinal Cord Disorders, National Hospital Organization, Hokkaido Medical Center, Sapporo, Japan

    Manabu Ito

  3. Industrial Research Institute, Industrial Technology Research Development, Hokkaido Research Organization, Sapporo, Japan

    Toshiyuki Akazawa

  4. Department of Oral and Maxillofacial Surgery, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu-cho, Japan

    Masaru Murata

  5. Division of Biomedical Engineering and Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan

    Toru Yamamoto

Authors
  1. Katsuhisa Yamada
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  2. Manabu Ito
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  3. Toshiyuki Akazawa
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  4. Masaru Murata
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  5. Toru Yamamoto
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  6. Norimasa Iwasaki
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Corresponding author

Correspondence to Katsuhisa Yamada.

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Yamada, K., Ito, M., Akazawa, T. et al. A preclinical large animal study on a novel intervertebral fusion cage covered with high porosity titanium sheets with a triple pore structure used for spinal fusion. Eur Spine J 24, 2530–2537 (2015). https://doi.org/10.1007/s00586-015-4047-2

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  • DOI: https://doi.org/10.1007/s00586-015-4047-2

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