PEEK Versus Ti Interbody Fusion Devices Resultant Fusion, Bone Apposition, Initial and 26-Week Biomechanics
PEEK Versus Ti Interbody Fusion Devices Resultant Fusion, Bone Apposition, Initial and 26-Week Biomechanics
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DOI：
10.1097/bsd.0b013e31826851a4
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发表时间：
2016-05-01
影响因子：
1.9
通讯作者：
Walsh, William R.
中科院分区：
文献类型：
--
作者：
Pelletier, Matthew Henry;Cordaro, Nicholas;Walsh, William R.
研究设计：在植骨体积相似的动物模型中，对聚醚醚酮（PEEK）与钛（Ti）椎间融合器的体外和体内生物力学、融合结果和组织形态计量学方面进行比较评价。目的：确定每种椎间融合器在植入后即刻（时间0）和26周时融合特征和生物力学的差异。背景数据总结：PEEK在脊柱手术中已被广泛接受，与金属植入物（如钛）相比，它提供了与骨机械性能更接近的匹配。这被认为可以减少椎间融合器的移植物应力遮挡和下沉。作为影响融合和初始稳定性的一个因素，这一点的总体影响仍存在争议。虽然材料模量是一个重要的因素，其他设计因素很可能发挥很大的作用，决定整体性能的interbody implant.Methods：一个钛和PEEK设备的类似大小的中央空隙，以容纳移植材料进行了比较。PEEK器械的尾部和头部表面有脊状表面，而钛器械允许轴向顺应性，并具有骨长入终板和抛光内表面。在9只绵羊中进行了双节段ALIF，并在26周时评价了融合、生物力学和骨附着。时间0在体外生物力学测试进行建立初始稳定性implantation.Results后立即：在体外时间0测试中，每个设备的生物力学测量没有差异。与体外试验相比，所有节段均在26周时融合，活动度明显降低。与轴向旋转（Ti-74%，PEEK-71%）、侧弯（Ti-90%，PEEK-88%）和屈曲/伸展（Ti-92%，PEEK-91%）的完整值相比，所有弯曲模式下的活动度均减少了70%以上。每种植入物形成的融合的机械性能没有差异;但是，骨附着是可变的，抛光的内部钛表面低于PEEK，经处理的钛终板显示出最高水平。移植物材料显示轴向骨小梁对齐与both implants.Conclusions：虽然材料特性和表面特性导致不同数量的生物整合从主机，两种植入物都能够产生良好的融合效果，使用类似的体积的骨移植。
Study Design: Comparative evaluation of in vitro and in vivo biomechanics, resulting fusion and histomorphometric aspects of polyetheretherketone (PEEK) versus titanium (Ti) interbody fusion devices in an animal model with similar volumes of bone graft.Objective: Identify differences in the characteristics of fusion and biomechanics immediately following implantation (time 0) and at 26 weeks with each interbody implant.Summary of Background Data: PEEK has been well accepted in spinal surgery, it provides a closer match to the mechanical properties of bone than metallic implants such as Ti. This is thought to reduce graft stress shielding and subsidence of interbody fusion devices. There remains controversy as to the overall influence of this as a factor influencing resultant fusion and initial stability. Although material modulus is 1 factor of importance, other design factors are likely to play a large role determining overall performance of an interbody implant.Methods: A Ti and PEEK device of similar size with a central void to accommodate graft material were compared. The PEEK device had a ridged surface on the caudal and cephalad surfaces, whereas Ti device allowed axial compliance and had bone ingrowth endplates and polished internal surfaces. A 2-level ALIF was performed in 9 sheep and fusion, biomechanics, and bone apposition were evaluated at 26 weeks. Time 0 in vitro biomechanical tests were performed to establish initial stability immediately after implantation.Results: No differences were detected in the biomechanical measures of each of the devices in in vitro time 0 tests. All levels were fused by 26 weeks with considerably lower range of motion when compared with in vitro tests. Range of motion in all modes of bending was reduced by over 70% when compared with intact values for axial rotation (Ti-74%, PEEK-71%), lateral bending (Ti-90%, PEEK-88%), and flexion/extension (Ti-92%, PEEK-91%). Mechanical properties of fusions formed with each implant did not differ; however, bone apposition was variable with polished internal Ti surfaces being lower than PEEK and treated Ti endplates showing the greatest levels. Graft material displayed axial trabecular alignment with both implants.Conclusions: Although material properties and surface characteristics resulted in differing amounts of biological integration from the host, both implants were capable of producing excellent fusion results using similar volumes of bone graft.