Biomaterials in Spinal Implants: A Review

Warburton, Andrew; Girdler, Steven J; Mikhail, Christopher; Ahn, Amy; Cho, Samuel K.

doi:10.14245/ns.1938296.148

Cited by 114 publications

(94 citation statements)

References 95 publications

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“…1g, h). The rostral and caudal stumps of the transected spinal cord remain aligned with the scaffold, while in the control animals, typical symptoms of intermediate and chronic secondary spinal cord injuries were apparent 9,16,23,24,42–44 .…”

Section: Resultsmentioning

confidence: 99%

Plant Scaffolds Support Motor Recovery and Regeneration in Rats after Traumatic Spinal Cord Injury

Modulevsky

Cuerrier

Leblanc-Latour

et al. 2020

Preprint

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As of yet, no standard of care incorporates the use of a biomaterial to treat traumatic spinal cord injury (SCI). However, intense development of biomaterials for treating SCI have focused on the fabrication of microscale channels to support the regrowth of axons while minimizing scar tissue formation. We previously demonstrated that plant tissues can be decellularized and processed to form sterile, biocompatible and implantable biomaterials that support cell infiltration and vascularization in vivo. Notably, the vascular bundles of plant tissues are also composed of microscale channels with geometries thought to be relevant for supporting neural tissue regeneration. We hypothesized that decellularized vascular bundles would support neural regeneration and the recovery of motor function. Therefore, rats which received a complete T8-T9 spinal cord transection were implanted with plant-derived channeled scaffolds. Animals which received the scaffolds alone, with no therapeutic stem cells or other interventions, demonstrated a significant and stable improvement in motor function over six months compared to controls. Histological analysis reveals minimal scarring and axonal regrowth through the scaffolds, further confirmed with tracer studies. Taken together, our work defines a novel route for exploiting naturally occurring plant microarchitectures to support the repair of functional spinal cord tissue.

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Section: Resultsmentioning

confidence: 99%

Plant Scaffolds Support Motor Recovery and Regeneration in Rats after Traumatic Spinal Cord Injury

Modulevsky

Cuerrier

Leblanc-Latour

et al. 2020

Preprint

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“…However, pedicle screw loosening is a common problem presented by the current screw design and material. If the optimal pedicle screw could act as a fusion material with long-lasting bone integration, it could potentially avoid the preparation of additional fusion areas and surgical interventions, such as posterolateral fusion or interbody fusion [ 43 ]. Nonetheless, excellent mechanical fixation and stabilization of pedicle screws require strong bone–implant interface bonding and direct biological anchorage to the surrounding bone tissue [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Investigation of Bone Growth in Additive-Manufactured Pedicle Screw Implant by Using Ti-6Al-4V and Bioactive Glass Powder Composite

Lam

Trinh

Huang

et al. 2020

IJMS

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In this study, we optimized the geometry and composition of additive-manufactured pedicle screws. Metal powders of titanium-aluminum-vanadium (Ti-6Al-4V) were mixed with reactive glass-ceramic biomaterials of bioactive glass (BG) powders. To optimize the geometry of pedicle screws, we applied a novel numerical approach to proposing the optimal shape of the healing chamber to promote biological healing. We examined the geometry and composition effects of pedicle screw implants on the interfacial autologous bone attachment and bone graft incorporation through in vivo studies. The addition of an optimal amount of BG to Ti-6Al-4V leads to a lower elastic modulus of the ceramic-metal composite material, effectively reducing the stress-shielding effects. Pedicle screw implants with optimal shape design and made of the composite material of Ti-6Al-4V doped with BG fabricated through additive manufacturing exhibit greater osseointegration and a more rapid bone volume fraction during the fracture healing process 120 days after implantation, per in vivo studies.

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“…Initially, stainless steel (SS) was the most commonly used alloy, but since the 2000s there has been a shift toward titanium (Ti) alloy, 4 mainly due to issues with biocompatibility, infection rates, and MRI distortions. [5][6][7] Currently, a trend toward cobalt-chromium (CoCr) alloys to replace Ti rods is ongoing. CoCr is a stronger material and has fewer disadvantages than SS, such as better MRI compatibility and biocompatibility.…”

mentioning

confidence: 99%

Cobalt-chromium versus titanium alloy rods for correction of adolescent idiopathic scoliosis based on 1-year follow-up: a multicenter randomized controlled clinical trial

Sakai

Tanaka

Takahashi

et al. 2021

Journal of Neurosurgery: Spine

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OBJECTIVE For instrumented correction surgery for adolescent idiopathic scoliosis (AIS), surgeons are increasingly switching from titanium (Ti) alloy rods to stiffer cobalt-chromium (CoCr) rods. The authors conducted the first multicenter randomized controlled clinical trial to investigate whether these materials affect the outcomes in terms of spine correction and quality of life (QOL). This trial was registered at UMIN Clinical Trials Registry on September 3, 2012, under the identifier UMIN000008838 (level of evidence 1). METHODS Female AIS patients (Lenke types 1–3, patient age 10–19 years) were recruited at 5 Japanese institutions and randomized into two cohorts: 6.0-mm-diameter Ti rods were placed in one group, and 6.0-mm-diameter CoCr rods were placed in the other. Patients were followed up at 2 weeks and 3, 6, and 12 months with radiographic examination to quantify the sagittal and coronal correction (Cobb angle, thoracic kyphosis, rib hump, and apical vertebral rotation). Patients completed questionnaires (Scoliosis Research Society–22r, 12-Item Short-Form Health Survey, and Scoliosis Japanese Questionnaire–27) at 6 and 12 months to assess QOL. RESULTS A total of 69 AIS patients were randomized to the demographically similar Ti (n = 37) or CoCr (n = 32) cohort. Four adverse events were recorded, two in each cohort, but these were not related to the rod material. At the final follow-up, both Ti and CoCr cohorts showed significant improvement in spinal correction, including the Cobb angle, thoracic kyphosis, and rib hump size. The correction rates were 68.4% and 67.1% for the Ti and CoCr cohorts, respectively. No parameters differed significantly between the cohorts at any time. Survey data showed improved but similar outcomes in both cohorts. CONCLUSIONS Both treatments (Ti and CoCr) produced similar results and were efficient in engendering clinically significant spine corrections. Clinical trial registration no.: UMIN000008838 (UMIN Clinical Trials Registry)

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Biomaterials in Spinal Implants: A Review

Cited by 114 publications

References 95 publications

Plant Scaffolds Support Motor Recovery and Regeneration in Rats after Traumatic Spinal Cord Injury

Plant Scaffolds Support Motor Recovery and Regeneration in Rats after Traumatic Spinal Cord Injury

Investigation of Bone Growth in Additive-Manufactured Pedicle Screw Implant by Using Ti-6Al-4V and Bioactive Glass Powder Composite

Cobalt-chromium versus titanium alloy rods for correction of adolescent idiopathic scoliosis based on 1-year follow-up: a multicenter randomized controlled clinical trial

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