Biocompatibility of carbon fiber interbody fusion cage versus titanium mesh cage in treatment of lumbar disc degeneration

doi:10.3969/j.issn.2095-4344.2015.12.020

Abstract

Abstract:

BACKGROUND: The endplate can be combined closely with different intervertebral fusion cages through the pedicle screw internal fixation system, to provide a more reliable spine stability for reconstruction of intervertebral height, lumbar physiological curvature and biomechanical function.
OBJECTIVE: To compare the effectiveness of carbon fiber interbody fusion cage and titanium mesh cage in lumbar disc degeneration.
METHODS: Sixty patients with L3-S1 lumbar disc degeneration who underwent posterior lumbar interbody fusion, 33 males and 27 females, were randomized into carbon fiber interbody fusion cage group and titanium mesh cage group. Japanese Orthopaedic Association Scores were compared between the two groups before and after the implantation, as well as the intervertebral height, intervertebral fusion and complications.
RESULTS AND CONCLUSION: Sixty patients completed the 3-27 months follow-up, and had good bone fusion. Lumbar activity was normal in all the patients at 3 months after treatment. The Japanese Orthopaedic Association Scores at 3 months after implantation and the intervertebral height at 1 week after implantation were significantly improved in the two groups (P < 0.05), but there was no difference between the two groups. The materials in the two groups had good biocompatibility with no rejection and no infection. Fusion cage subsidence occurred in two cases from the titanium mesh cage group. These findings indicate that both of carbon fiber interbody fusion cage and titanium mesh cage have good biocompatibility, improve the stability of the vertebral body, and restore the intervertebral height. Moreover, the carbon fiber material performance is better than the metal titanium mesh because of lower complication rate.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: Spinal Fusion, Lumbar Vertebrae, Biocompatible Materials

CLC Number:

R318

Song Cheng-zhe, Jin Hong-xu. Biocompatibility of carbon fiber interbody fusion cage versus titanium mesh cage in treatment of lumbar disc degeneration[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(12): 1909-1913.

Figures/Tables 2

2.1 受试者数量分析 60例患者均进入结果分析，无脱落。 2.2 随访情况随访3-27个月，平均13.8个月，行腰椎X射线正侧位和过伸过屈动力位片、CT检查等。 2.3 两组治疗前后的JOA评分、椎间高度及植骨融合比较两组治疗后的临床症状和神经功能障碍均得到不同程度改善，两组手术时间、术中出血量比较差异无显著性意义(P > 0.05)，JOA评分、椎间高度与治疗前比较明显改善(P < 0.05)，但两组间比较差异无显著性意义(P > 0.05)，见表1，2。所有患者经X射线等检查植骨融合良好，无明显神经压迫，均获得良好的融合率，融合器周围无透亮线，有骨小梁形成。融合时间平均为10.4个月，治疗后3个月患者腰部活动基本正常，较治疗前有明显改善。 2.4 两种融合器的材料生物相容性正常人体液的pH值是7.4，含有盐电解质和有机分子及细胞，可加快植入物的化学反应，钛合金由于表面生成致密稳定的钝化膜，置入腰椎后起到很强的抗腐蚀作用。钛合金还具有易加工性能、成本低廉等优点，生物相容性良好，融合器置入人体后炎症反应逐渐消失，长期观察无炎症反应，无排斥反应，无明显不良反应。钛合金具有一定的强度和刚度，可以即刻重建腰椎稳定性，促进骨性融合。新型的钛合金材料虽然在成分上有所改进，以达到降低材料弹性模量的作用，弹性模量在70-100 GPa，但仍然高于人体正常骨的3-20 GPa。碳纤维融合器完整的骨性结构增大上下椎体的骨融合面积，具有良好的生物相容性，接近人体骨弹性模量，具有满足临床需要的抗压强度，表面齿状突起不易脱落，碳纤维组未出现排异反应现象，无感染发生。 2.5 并发症随访发现钛网组2例出现下沉，发生时间在治疗后3-6个月，但并不影响手术疗效，也没有导致症状复发。由于碳纤维材料的抗压、刚度和弹性模量与人体皮质骨相似，碳纤维组未出现融合器下沉，无融合器移位，术后患者椎间高度得以恢复。 2.6 典型病例 56岁男性患者，因腰痛、右下肢酸痛跛行症状入院，诊断L4-5腰椎间盘突出，采用碳纤维椎间融合器行后路椎间融合，椎弓根钉系统辅助固定，术后患者症状完全缓解，恢复椎间高度，植骨融合良好，见图2。"

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