Highly Effective Bone Fusion Induced by the Interbody Cage Made of Calcium Silicate/Polyetheretherketone in a Goat Model

Abstract

Interbody fusion surgery is often used to settle matters such as degenerative disc disease or disc herniation in clinical orthopedics. Considering the deficiencies of the current treatment methods, we developed an interbody fusion cage made of calcium silicate (CS)/polyetheretherketone (PEEK) and hoped that the bioactive cage could exhibit great fusion ability and maintain stable mechanical function. In the goat model of cervical interbody fusion, the CS/PEEK cage showed stronger interbody fusion at 12 and 26 weeks compared with pure PEEK cage based on the X-ray analysis. The micro-CT scanning and analysis indicated that the CS/PEEK cage induced more new bone ingrowth than the PEEK cage and led to nearly complete interbody fusion at 26 weeks. Moreover, the CS/PEEK group showed excellent mechanical stability and stiffness as evaluated by the spine kinematic assay at the time points. The histological assessment showed the rapid osseointegration and mineralized bone formation around the CS/PEEK cage. This study confirmed that the bioactive CS/PEEK cage is capable of inducing highly effective bone fusion and has high potential to be used in the clinics of spine surgery.

Preliminary results in anterior cervical discectomy and fusion with the uncovertebral joint fusion cage in a goat model

“…In the present study, X-rays, CT scans, micro-CT scans and histological analysis were selected for determining spinal fusion quality. The critical time points for this study were 12 and 24 weeks for evaluation of fusion [21][22][23].…”

Biomaterials for Interbody Fusion in Bone Tissue Engineering

“…PEEK is a kind of high-molecular-weight semi-crystal polyaromatic linear polymer and thermoplastic material characterized by biological inertia, radiation transmission, low density, strong corrosion resistance, and a bone-like hardness ( Basgul et al, 2019 ). Compared to alloy, PEEK can minimize stress shielding and bone resorption around the implant to avoid implant loosening ( McGilvray et al, 2018 ; Chu et al, 2019 ). However, the formation of a biofilm on the surface of PEEK inhibits its binding to the host bone, preventing solid fusion ( McGilvray et al, 2017 ; Gunzburg et al, 2019 ).…”

“…Through the analysis of the results from a goat interbody fusion model, it was found that the CS/PEEK composite had good biomechanical stability, osteogenic effects, and osseointegration ability. This bioactive material has great potential to facilitate the development of clinical interbody fusion cages ( Chu et al, 2019 ) ( Figure 4 ).…”

“…(C) 3D and longitudinal images of the interbody fusion of bone formation in the interbody fusion at 4, 12, and 26 weeks based on the micro-CT scans. (D) Analysis of osseointegration at 4, 12, and 26 weeks based on histological assessment, including Van Gieson staining and fluorescence labeling by calcein ( Chu et al, 2019 ).…”

Biomechanics of a novel artificial cervical vertebra from an in vivo caprine cervical spine non-fusion model

“…Previous studies have reported that the cervical spine of goat is an ideal model for spinal implants [ 19 , 20 ]. We thus established an in vivo cervical spine non-fusion model by implantation of an ADVS specially designed for goat.…”