Computational comparison of three posterior lumbar interbody fusion techniques by using porous titanium interbody cages with 50% porosity

Lee, Yung‐Heng; Chung, Chi-Jen; Wang, Chih‐Wei; Peng, Yao-Te; Chang, Chih‐Han; Chen, Chih-Hsien; Chen, Yen-Nien; Li, Chunting

doi:10.1016/j.compbiomed.2016.01.024

Cited by 56 publications

(31 citation statements)

References 49 publications

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“…Similarly, stiffness data showed a significant and positive correlation to bone maturation for the PTC group at all time points for all loading directions (the 8-, 12-, and 16-week correlation coefficients were 0.83±0.18, 0.91±0.01, and 0.86±0.05, respectively, with all p≤.04). These data mirror the findings of previously reported computational and comparative animal studies that have also demonstrated that bone ingrowth into porous titanium cages results in increased implant stability [35][36][37]. The data suggest that by providing a microporous layer of titanium on the contact surface of PEEK devices, cells may form a bony ongrowth or ingrowth on the surface, leading to greater overall mechanical construct stability and efficacy as a fusionpromoting device.…”

Section: Discussionsupporting

confidence: 88%

Evaluation of a polyetheretherketone (PEEK) titanium composite interbody spacer in an ovine lumbar interbody fusion model: biomechanical, microcomputed tomographic, and histologic analyses

et al. 2017

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Section: Discussionsupporting

confidence: 88%

Evaluation of a polyetheretherketone (PEEK) titanium composite interbody spacer in an ovine lumbar interbody fusion model: biomechanical, microcomputed tomographic, and histologic analyses

et al. 2017

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“…Spinal interbody fusion cages are scaffolds inserted in the body after complete or partial surgical removal of an intervertebral disc. Cages are designed to bear mechanical load while providing a biological niche for vertebral fusion [ 20 – 23 ]. Once a cage is inserted in the body, it bears spinal loads and provides a scaffolding for cells to populate and begin forming bone that eventually creates one solid bone fusion bridging the adjacent vertebrae.…”

Section: Introductionmentioning

confidence: 99%

Computationally designed lattices with tuned properties for tissue engineering using 3D printing

Gonella²,

et al. 2017

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Tissue scaffolds provide structural support while facilitating tissue growth, but are challenging to design due to diverse property trade-offs. Here, a computational approach was developed for modeling scaffolds with lattice structures of eight different topologies and assessing properties relevant to bone tissue engineering applications. Evaluated properties include porosity, pore size, surface-volume ratio, elastic modulus, shear modulus, and permeability. Lattice topologies were generated by patterning beam-based unit cells, with design parameters for beam diameter and unit cell length. Finite element simulations were conducted for each topology and quantified how elastic modulus and shear modulus scale with porosity, and how permeability scales with porosity cubed over surface-volume ratio squared. Lattices were compared with controlled properties related to porosity and pore size. Relative comparisons suggest that lattice topology leads to specializations in achievable properties. For instance, Cube topologies tend to have high elastic and low shear moduli while Octet topologies have high shear moduli and surface-volume ratios but low permeability. The developed method was utilized to analyze property trade-offs as beam diameter was altered for a given topology, and used to prototype a 3D printed lattice embedded in an interbody cage for spinal fusion treatments. Findings provide a basis for modeling and understanding relative differences among beam-based lattices designed to facilitate bone tissue growth.

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“…Because 3D printing is an additive manufacturing technique, the porosity and roughness of a surface can be appropriately adjusted using this technique. Previous studies have reported that a titanium alloy implant with appropriate porosity or roughness can enhance tissue integration [11,12,15,[17][18][19][20][21]. However, to our knowledge, this potential has not yet been evaluated in a clinical application in humans.…”

Section: Discussionmentioning

confidence: 96%

“…Unlike the traditional metal casting method, 3D printing technology facilitates the production of implants with a constant internal pore. A few in vitro studies and in vivo animal experiments have demonstrated the potential of a titanium alloy implant with appropriate porosity to enhance the osseointegration of implants [11,12,15,[17][18][19][20][21]. Some studies have developed titanium alloy implants with a bioactive coating-however, animal and in vitro studies on these implants are still underway [22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Integration of a Three-Dimensional-Printed Titanium Implant in Human Tissues: Case Study

et al. 2020

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A titanium alloy implant of appropriate pore size can potentially enhance osseointegration and soft tissue integration. However, the human clinical application of such implants has not been reported. Here, we present a case of limb salvage surgery for a bone tumor using customized three-dimensional (3D)-printed Ti6Al4V radius and ulna implants. The patient presented with local recurrence at the proximal junction of the ulna and underwent a re-wide excision. Single forearm bone surgery was performed using another 3D-printed implant after resection of the recurrent tumor with an ulnar implant. Host osseointegration and soft tissue integration of the retrieved implant were quantified through histological evaluation. The total tissue integration rates of the implant at the proximal and distal bone junctions were 45.96% and 15.03%, respectively. The mesh structure enhanced bone integration by up to 10.81% in the proximal and by up to 8.91% in the distal bone junction. Furthermore, the soft tissue adhesion rates of the implant shaft were 59.50% and 50.26% in the axial and longitudinal cuts, respectively. No area was left unoccupied throughout the shaft of the implant. Overall, these results indicate that the 3D-printed Ti6Al4V titanium alloy implant with a rough surface has considerable tissue integration ability.

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Computational comparison of three posterior lumbar interbody fusion techniques by using porous titanium interbody cages with 50% porosity

Cited by 56 publications

References 49 publications

Evaluation of a polyetheretherketone (PEEK) titanium composite interbody spacer in an ovine lumbar interbody fusion model: biomechanical, microcomputed tomographic, and histologic analyses

Evaluation of a polyetheretherketone (PEEK) titanium composite interbody spacer in an ovine lumbar interbody fusion model: biomechanical, microcomputed tomographic, and histologic analyses

Computationally designed lattices with tuned properties for tissue engineering using 3D printing

Integration of a Three-Dimensional-Printed Titanium Implant in Human Tissues: Case Study

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