Artificial intervertebral disc replacement using bioactive three-dimensional fabric - Design, development, and preliminary animal study
Artificial intervertebral disc replacement using bioactive three-dimensional fabric - Design, development, and preliminary animal study
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DOI：
10.1097/00007632-200205010-00008
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发表时间：
2002-05-01
期刊：
影响因子：
3
通讯作者：
Kaneda, K
中科院分区：
文献类型：
--
作者：
Kotani, Y;Abumi, K;Kaneda, K
研究设计。研制了一种新型人工腰椎间盘，并对其内在的生物力学特性、生物活性及其作为全盘置换的有效性进行了体内外评价。介绍一种新型人工腰椎间盘，并评价其体外力学性能、与骨的融合能力和节段生物力学性能。在以前的人工椎间盘中，已经有过骨-种植体界面生物融合的丢失和假体失败的报道。目前还没有临床适用的能对体内力学和界面融合能力进行详细实验测试的圆盘。该人工椎间盘由超高相对分子质量聚乙烯纤维编织的三轴三维织物(3-DF)和在其表面喷涂生物活性陶瓷组成。编织性能的排列被设计成产生几乎等同于自然椎间盘的力学行为。在绵羊腰椎模型上，采用3-DF型椎间盘内固定或不内固定进行L2-L3和L4-L5的全椎间盘置换术。术后4个月和6个月分别进行节段生物力学和界面组织学评价。原型3-DF的拉伸、压缩和扭转性能与人腰椎间盘基本相当。在6个月时，仅用3-DF盘替代的腰椎节段显示屈伸活动范围显着减少至对照组的28%，部分骨性融合。然而，临时内固定的使用提供了植入物取出后脊柱节段接近生理性的活动度以及在6个月时良好的骨盘融合。使用三维织物的人工椎间盘在生物力学和界面组织学方面都显示出良好的体外和体内性能。在未来的临床应用中有很大的潜力。
Study Design. A new artificial intervertebral disc was developed, and its intrinsic biomechanical properties, bioactivity, and the effectiveness as a total disc replacement were evaluated in vitro and in vivo.Objectives. To introduce a new artificial intervertebral disc and to evaluate the in vitro mechanical properties, fusion capacity to bone, and segmental biomechanics in the total intervertebral disc replacement using a sheep lumbar spine.Summary of Background Data. The loss of biologic fusion at the bone-implant interface and prosthetic failures have been reported in previous artificial discs. There have been no clinically applicable discs with detailed experimental testing of in vivo mechanics and interface fusion capacity.Methods. The artificial intervertebral disc consists of a triaxial three-dimensional fabric (3-DF) woven with an ultra-high molecular weight polyethylene fiber, and spray-coated bioactive ceramics on the disc surface. The arrangement of weave properties was designed to produce mechanical behavior nearly equivalent to the natural intervertebral disc. Total intervertebral disc replacement at L2-L3 and L4-L5 was performed using 3-DF disc with or without internal fixation in a sheep lumbar spine model. The segmental biomechanics and interface histology were evaluated after surgery at 4 and 6 months.Results. The tensile-compressive and torsional properties of prototype 3-DF were nearly equivalent to those of human lumbar disc. The lumbar segments replaced with 3-DF disc alone showed a significant decrease of flexion-extension range of motion to 28% of control values as well as partial bony fusion at 6 months. However, the use of temporary fixation provided a nearly physiologic mobility of the spinal segment after implant removal as well as excellent bone-disc fusion at 6 months.Conclusion. An artificial intervertebral disc using a three-dimensional fabric demonstrated excellent in vitro and in vivo performance in both biomechanics and interface histology. There is a potential for future clinical application.