First Results of a New Vacuum Plasma Sprayed (VPS) Titanium-Coated Carbon/PEEK Composite Cage for Lumbar Interbody Fusion.
First Results of a New Vacuum Plasma Sprayed (VPS) Titanium-Coated Carbon/PEEK Composite Cage for Lumbar Interbody Fusion.
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DOI：
10.3390/jfb9010023
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发表时间：
2018-03-14
影响因子：
4.8
通讯作者：
Benneker LM
中科院分区：
文献类型：
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作者：
Hoppe S;Albers CE;Elfiky T;Deml MC;Milavec H;Bigdon SF;Benneker LM
本研究旨在评估新型真空等离子喷涂（VPS）钛涂层碳/聚醚醚酮（PEEK）椎间融合器在首次使用临床条件下的性能。通过电子病历审查，回顾性识别了2012年至2016年间使用新型Ca/PEEK复合椎间融合器接受单节段或两节段经椎间孔腰椎椎间融合术（TLIF）的42例患者。随访2年，观察融合率（使用X线）、患者满意度和并发症。在29.1 ± 9（范围24-39）个月的随访（FU）期后，共有90.4%的患者无疼痛且满意。早期节段性脊柱前凸平均增加3°（p = 0.002），最终随访时恢复至术前水平。根据Bridwell分级，计算出24个月G1融合率平均值为93.6%，G2融合率平均值为6.4%。椎间融合器周围无射线可透性（G3）或可见明显假关节（G4）。总之，惰性疏水表面的生物学性能（这是PEEK的主要缺点）可以通过VPS钛涂层得到改善，因此在生物力学性能方面具有巨大优势的碳/PEEK复合椎间融合器可以安全地用于TLIF手术。无需使用rhBMP或额外的髂骨移植物即可实现高融合率、良好的临床结局和低植入物相关并发症发生率。
The aim of this study was to assess the performance of a new vacuum plasma sprayed (VPS) titanium-coated carbon/polyetheretherketone (PEEK) cage under first use clinical conditions. Forty-two patients who underwent a one or two segment transforaminal lumbar interbody fusion (TLIF) procedure with a new Ca/PEEK composite cage between 2012 and 2016 were retrospectively identified by an electronic patient chart review. Fusion rates (using X-ray), patient’s satisfaction, and complications were followed up for two years. A total of 90.4% of the patients were pain-free and satisfied after a follow up (FU) period of 29.1 ± 9 (range 24–39) months. A mean increase of 3° in segmental lordosis in the early period (p = 0.002) returned to preoperative levels at final follow-ups. According to the Bridwell classification, the mean 24-month G1 fusion rate was calculated as 93.6% and the G2 as 6.4%. No radiolucency around the cage (G3) or clear pseudarthrosis could be seen (G4). In conclusion, biological properties of the inert, hydrophobic surface, which is the main disadvantage of PEEK, can be improved with VPS titanium coating, so that the carbon/PEEK composite cage, which has great advantages in respect of biomechanical properties, can be used safely in TLIF surgery. High fusion rates, good clinical outcome, and low implant-related complication rates without the need to use rhBMP or additional iliac bone graft can be achieved.