Accelerated Cervical Fusion of Silicon Nitride versus PEEK Spacers: A Comparative Clinical Study

Ball, Hieu T; McEntire, Bryan J.; B, Sonny Bal

doi:10.4172/2165-7939.1000396

Cited by 10 publications

(4 citation statements)

References 37 publications

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“…Si 3 N 4 has been used for more than 15 years in the human body in contact with bone and soft tissue without any adverse effect being so far reported. 86 Moreover, several in vitro studies have shown the compatibility of Si 3 N 4 with different cells lines, including mature osteoblasts, 87 mesenchymal cells, 4 , 88 , 89 and primary odontoblasts. 90 As a fine micrometric powder, Si 3 N 4 can remain suspended in the air for some period, but its effect on human health is comparable to inert dust.…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of instantaneous inactivation of SARS-CoV-2 by silicon nitride bioceramic

Pezzotti¹,

Boschetto²,

Ohgitani³

et al. 2021

Materials Today Bio

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The hydrolytic processes occurring at the surface of silicon nitride (Si 3 N 4 ) bioceramic have been indicated as a powerful pathway to instantaneous inactivation of SARS-CoV-2 virus. However, the virus inactivation mechanisms promoted by Si 3 N 4 remain yet to be elucidated. In this study, we provide evidence of the instantaneous damage incurred on the SARS-CoV-2 virus upon contact with Si 3 N 4 . We also emphasize the safety characteristics of Si 3 N 4 for mammalian cells. Contact between the virions and micrometric Si 3 N 4 particles immediately targeted a variety of viral molecules by inducing post-translational oxidative modifications of S-containing amino acids, nitration of the tyrosine residue in the spike receptor binding domain, and oxidation of RNA purines to form formamidopyrimidine. This structural damage in turn led to a reshuffling of the protein secondary structure. These clear fingerprints of viral structure modifications were linked to inhibition of viral functionality and infectivity. This study validates the notion that Si 3 N 4 bioceramic is a safe and effective antiviral compound; and a primary antiviral candidate to replace the toxic and allergenic compounds presently used in contact with the human body and in long-term environmental sanitation.

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Section: Discussionmentioning

confidence: 99%

Mechanisms of instantaneous inactivation of SARS-CoV-2 by silicon nitride bioceramic

Pezzotti¹,

Boschetto²,

Ohgitani³

et al. 2021

Materials Today Bio

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“…A formulation of Si3N4 is FDA-cleared for use as an intervertebral spinal spacer in cervical and lumbar spine fusion surgery, with proven long-term safety, efficacy, and biocompatibility. Clinical data for Si3N4 implants compare favorably with other spine biomaterials, such as allograft, titanium, and polyetheretherketone [8][9][10][11][12][13]. A curious finding is that Si3N4 implants have a lower incidence of bacterial infection (i.e., less than 0.006%) when compared to other implant materials (2.7% to 18%) [14].…”

Section: Introductionmentioning

confidence: 99%

Rapid Inactivation of SARS-CoV-2 by Silicon Nitride, Copper, and Aluminum Nitride

Pezzotti

Ohgitani

Shin‐Ya

et al. 2020

Preprint

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IntroductionViral disease spread by contaminated commonly touched surfaces is a global concern. Silicon nitride, an industrial ceramic that is also used as an implant in spine surgery, has known antibacterial activity. The mechanism of antibacterial action relates to the hydrolytic release of surface disinfectants. It is hypothesized that silicon nitride can also inactivate the coronavirus SARS-CoV-2.Methods SARS-CoV-2 virions were exposed to 15 wt.% aqueous suspensions of silicon nitride, aluminum nitride, and copper particles. The virus was titrated by the TCD50 method using VeroE6/TMPRSS2 cells, while viral RNA was evaluated by real-time RT-PCR. Immunostaining and Raman spectroscopy were used as additional probes to investigate the cellular responses to virions exposed to the respective materials. ResultsAll three tested materials showed >99% viral inactivation at one and ten minutes of exposure. Degradation of viral RNA was also observed with all materials. Immunofluorescence testing showed that silicon nitride-treated virus failed to infect VeroE6/TMPRSS2 cells without damaging them. In contrast, the copper-treated virus suspension severely damaged the cells due to copper ion toxicity. Raman spectroscopy indicated differential biochemical cellular changes due to infection and metal toxicity for two of the three materials tested. ConclusionsSilicon nitride successfully inactivated the SARS-CoV-2 in this study. The mechanism of action was the hydrolysis-mediated surface release of nitrogen-containing disinfectants. Both aluminum nitride and copper were also effective in the inactivation of the virus. However, while the former compound affected the cells, the latter compound had a cytopathic effect. Further studies are needed to validate these findings and investigate whether silicon nitride can be incorporated into personal protective equipment and commonly touched surfaces, as a strategy to discourage viral persistence and disease spread.

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“…17 Silicon nitride (Si3N4) is a non-oxide ceramic that is FDA-cleared for use in implantable spinal fusion devices; clinical data have shown excellent long-term outcomes in both lumbar and cervical fusion with Si3N4 when compared to other spine biomaterials such as bone grafts, titanium, and polyetheretherketone. [18][19][20][21][22][23] In aqueous environments, Si3N4 spine implants undergo surface hydrolysis, resulting in the microscopic elution of ammonia which is converted into ammonium, nitrous oxide, and other reactive nitrogen species that inhibit bacterial growth and proliferation. 24 This inherent resistance to bacterial colonization may explain the lower incidence of bacterial infection with Si3N4 spinal implants (< 0.006%) when compared to other spine biomaterials (2.7% to 18%).…”

Section: Introductionmentioning

confidence: 99%

Silicon Nitride Inactivates SARS-CoV-2in vitro

Lehman

Flur

Kehn-Hall

et al. 2020

Preprint

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IntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for the COVID-19 pandemic, remains viable and therefore potentially infectious on several materials. One strategy to discourage the fomite-mediated spread of COVID-19 is the development of materials whose surface chemistry can spontaneously inactivate SARS-CoV-2. Silicon nitride (Si3N4), a material used in spine fusion surgery, is one such candidate because it has been shown to inactivate several bacterial species and viral strains. This study hypothesized that contact with Si3N4 would inactivate SARS-CoV-2, while mammalian cells would remain unaffected.MaterialsSARS-CoV-2 virions (2×104 PFU/mL diluted in growth media) were exposed to 5, 10, 15, and 20% (w/v) of an aqueous suspension of sintered Si3N4 particles for durations of 1, 5, and 10 minutes, respectively. Before exposure to the virus, cytotoxicity testing of Si3N4 alone was assessed in Vero cells at 24 and 48 hour post-exposure times. Following each exposure to Si3N4, the remaining infectious virus was quantitated by plaque assay.ResultsVero cell viability increased at 5% and 10% (w/v) concentrations of Si3N4 at exposure times up to 10 minutes, and there was only minimal impact on cell health and viability up to 20% (w/v). However, the SARS-CoV-2 titers were markedly reduced when exposed to all concentrations of Si3N4; the reduction in viral titers was between 85% - 99.6%, depending on the dose and duration of exposure.ConclusionsSi3N4 was non-toxic to the Vero cells while showing strong antiviral activity against SARS-CoV-2. The viricidal effect increased with increasing concentrations of Si3N4 and longer duration of exposure. Surface treatment strategies based on Si3N4 may offer novel methods to discourage SARS-CoV-2 persistence and infectivity on surfaces and discourage the spread of COVID-19.

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Accelerated Cervical Fusion of Silicon Nitride versus PEEK Spacers: A Comparative Clinical Study

Cited by 10 publications

References 37 publications

Mechanisms of instantaneous inactivation of SARS-CoV-2 by silicon nitride bioceramic

Mechanisms of instantaneous inactivation of SARS-CoV-2 by silicon nitride bioceramic

Rapid Inactivation of SARS-CoV-2 by Silicon Nitride, Copper, and Aluminum Nitride

Silicon Nitride Inactivates SARS-CoV-2in vitro

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