Pei-I Tsai1, Meng-Huang Wu2,3, Yen-Yao Li4,5, Tzu-Hung Lin6, Jane S C Tsai1, Hsin-I Huang1, Hong-Jen Lai7, Ming-Hsueh Lee8,9, Chih-Yu Chen10,11. 1. Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu, Taiwan. 2. Department of Orthopedics, Taipei Medical University Hospital, Taipei, Taiwan. 3. Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 4. Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. 5. College of Medicine, Chang Gung University, Taoyuan, Taiwan. 6. Material and Chemical Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu, Taiwan. 7. Material and Chemical Research Laboratories, Industrial Technology Research Institute, Hsinchu, 31040, Taiwan. 8. Department of Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 61363, Taiwan. maxwutmu@gmail.com. 9. Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan. maxwutmu@gmail.com. 10. Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. aleckc2424@gmail.com. 11. Department of Orthopedics, Shuang-Ho Hospital, Taipei Medical University, No.291, Zhongzheng Rd., Zhonghe District, New Taipei City, 23561, Taiwan. aleckc2424@gmail.com.
Abstract
BACKGROUND: We developed a porous Ti alloy/PEEK composite interbody cage by utilizing the advantages of polyetheretherketone (PEEK) and titanium alloy (Ti alloy) in combination with additive manufacturing technology. METHODS: Porous Ti alloy/PEEK composite cages were manufactured using various controlled porosities. Anterior intervertebral lumbar fusion and posterior augmentation were performed at three vertebral levels on 20 female pigs. Each level was randomly implanted with one of the five cages that were tested: a commercialized pure PEEK cage, a Ti alloy/PEEK composite cage with nonporous Ti alloy endplates, and three composite cages with porosities of 40, 60, and 80%, respectively. Micro-computed tomography (CT), backscattered-electron SEM (BSE-SEM), and histological analyses were performed. RESULTS: Micro-CT and histological analyses revealed improved bone growth in high-porosity groups. Micro-CT and BSE-SEM demonstrated that structures with high porosities, especially 60 and 80%, facilitated more bone formation inside the implant but not outside the implant. Histological analysis also showed that bone formation was higher in Ti alloy groups than in the PEEK group. CONCLUSION: The composite cage presents the biological advantages of Ti alloy porous endplates and the mechanical and radiographic advantages of the PEEK central core, which makes it suitable for use as a single implant for intervertebral fusion.
BACKGROUND: We developed a porous Ti alloy/PEEK composite interbody cage by utilizing the advantages of polyetheretherketone (PEEK) and titanium alloy (Ti alloy) in combination with additive manufacturing technology. METHODS: Porous Ti alloy/PEEK composite cages were manufactured using various controlled porosities. Anterior intervertebral lumbar fusion and posterior augmentation were performed at three vertebral levels on 20 female pigs. Each level was randomly implanted with one of the five cages that were tested: a commercialized pure PEEK cage, a Ti alloy/PEEK composite cage with nonporous Ti alloy endplates, and three composite cages with porosities of 40, 60, and 80%, respectively. Micro-computed tomography (CT), backscattered-electron SEM (BSE-SEM), and histological analyses were performed. RESULTS: Micro-CT and histological analyses revealed improved bone growth in high-porosity groups. Micro-CT and BSE-SEM demonstrated that structures with high porosities, especially 60 and 80%, facilitated more bone formation inside the implant but not outside the implant. Histological analysis also showed that bone formation was higher in Ti alloy groups than in the PEEK group. CONCLUSION: The composite cage presents the biological advantages of Ti alloy porous endplates and the mechanical and radiographic advantages of the PEEK central core, which makes it suitable for use as a single implant for intervertebral fusion.
Entities:
Keywords:
4 V (Ti alloy)/polyetheretherketone (PEEK) composite porous cage, porcine study; 6Al; Additive manufacturing (3D printing), Ti
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