Artifacts in spine magnetic resonance imaging due to different intervertebral test spacers: an in vitro evaluation of magnesium versus titanium and carbon-fiber-reinforced polymers as biomaterials

Ernstberger, Thorsten; Buchhorn, Gottfried; Heidrich, Gabert

doi:10.1007/s00234-009-0537-4

Cited by 34 publications

(30 citation statements)

References 25 publications

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“…This figure rose to 33 in mean time of follow-up 1 and 37 in mean time of follow-up 2. In the group of patients without subsidence, the preoperative mean of 29 (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) increased to 30 (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) in mean time of follow-up 1 and 37 in mean time of follow-up 2. Here, too, there were no significant differences between the two groups (p = 0.54, α = 0.05).…”

Section: Resultsmentioning

confidence: 89%

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Is the radiographic subsidence of stand-alone cages associated with adverse clinical outcomes after cervical spine fusion: an observational cohort study with 2-year follow-up outcome scoring

et al. 2014

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Background: The stand-alone treatment of degenerative cervical spine pathologies is a proven method in clinical practice. However, its impact on subsidence, the resulting changes to the profile of the cervical spine and the possible influence of clinical results compared to treatment with additive plate osteosynthesis remain under discussion until present. Methods: This study was designed as a retrospective observational cohort study to test the hypothesis that radiographic subsidence of cervical cages is not associated with adverse clinical outcomes. 33 cervical segments were treated surgically by ACDF with stand-alone cage in 17 patients (11 female, 6 male), mean age 56 years (33-82 years), and re-examined after eight and twenty-six months (mean) by means of radiology and score assessment (Medical Outcomes Study Short Form (MOS-SF 36), Oswestry Neck Disability Index (ONDI), painDETECT questionnaire and the visual analogue scale (VAS)). Results: Subsidence was observed in 50.5% of segments (18/33) and 70.6% of patients (12/17). 36.3% of cases of subsidence (12/33) were observed after eight months during mean time of follow-up 1. After 26 months during mean time of follow-up 2, full radiographic fusion was seen in 100%. MOS-SF 36, ONDI and VAS did not show any significant difference between cases with and without subsidence in the two-sample t-test. Only in one type of scoring (painDETECT questionnaire) did a statistically significant difference in t-Test emerge between the two groups (p = 0.03; α = 0.05). However, preoperative painDETECT score differ significantly between patients with subsidence (13.3 falling to 12.6) and patients without subsidence (7.8 dropped to 6.3).

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Section: Resultsmentioning

confidence: 89%

“…The basic matrix consists of a combination of PEEK (polyether ether ketone) and carbon fibre re-embedded [26]. X-ray markers are embedded in the cage for visualization (Figure 2).…”

Section: Methodsmentioning

confidence: 99%

Is the radiographic subsidence of stand-alone cages associated with adverse clinical outcomes after cervical spine fusion: an observational cohort study with 2-year follow-up outcome scoring

et al. 2014

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“…[2][3][4][5][6][7] The choice of imaging sequence is essential to minimize artifacts. 15 Gradient-echo imaging is particularly artifact prone and should be avoided.…”

Section: Implants and Mr Artifactmentioning

confidence: 99%

Postoperative magnetic resonance imaging artifact with cobalt-chromium versus titanium spinal instrumentation

Ahmad¹,

Sidani

Fourzali

et al. 2013

SPI

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Object Cobalt-chromium alloy (CoCr) rods haves some preferred biomechanical properties over titanium rods for spinal fixation. The use of CoCr rods in spinal fusion is relatively new, and there is no study in the existing world literature assessing the artifact caused by these rods in patients undergoing postoperative MRI. The purpose of this study is to compare the amount of imaging artifact caused by these implants and to assess its impact on the visualization of neighboring neural structures. Methods This study investigated MR images in patients who underwent implantation of thoracolumbar instrumentation using 5.5-mm-diameter CoCr rods between November 2009 and March 2011 and images obtained in a comparison group of patients who had 5.5-mm titanium rods implanted during the same time period. Axial measurements of the artifact created by the rods between the screw heads were compared between the groups. Two blinded board-certified radiologists performed the measurements independently. They scored the visualization of the spinal canal using a subjective scoring system of 1–3, with 1 representing very good visualization and 2 and 3 representing reduced (good or suboptimal, respectively) visualization as a result of rod-related artifact. All measurements and scores were independently provided for T1-weighted and T2-weighted fast spin echo sequences (1.5-T magnet, 5-mm slice thickness). Results A total of 40 levels from the CoCr group (6 patients) and 30 levels from the titanium group (9 patients) were included in the analysis. Visualization of the canal at all levels was rated a score of 1 (very good) by both evaluators for both the CoCr and titanium groups. The average artifact on T1-weighted images measured 11.8 ± 1.8 mm for the CoCr group and 8.5 ± 1.2 mm for the titanium group (p < 0.01). The corresponding measurements on T2-weighted images were 11.0 ± 2.3 mm and 8.3 ± 1.7 mm (p < 0.01), respectively. In a mixed regression model, the mean artifact measurement for the CoCr group was, on average, 3.5 mm larger than for the control group. There was no significant difference between the measurements of the 2 evaluators (p = 0.99). Conclusions The artifact caused by CoCr rods is approximately 3.5 mm larger than that caused by titanium rods on axial T1- and T2-weighted MRI. However, artifact from either CoCr or titanium was not found to interfere with the evaluation of the spinal canal and surrounding neural elements.

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“…[ 20,21 ] Polymers also exhibit poor visibility characteristics; they are either transparent or have poor contrast in comparison to tissue, and lack radiopacity for in vivo imaging. [ 22 ] Further, hydrolytically degradable polymers show tendencies of swelling and bulk erosion and therefore lose integrity early and in an unpredictable way. [ 23,24 ] The lactide-glycolide degradation acts as a self-catalyst in environments with poor vascularisation, and the accumulation of byproducts can furthermore cause adverse tissue reactions due to a local reduction in pH.…”

Section: Reviewmentioning

confidence: 99%

Recent Advances in Biodegradable Metals for Medical Sutures: A Critical Review

Seitz

Ďurišin

Goldman

et al. 2015

Adv Healthcare Materials

208

158

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Sutures that biodegrade and dissolve over a period of several weeks are in great demand to stitch wounds and surgical incisions. These new materials are receiving increased acceptance across surgical procedures whenever permanent sutures and long-term care are not needed. Unfortunately, both inflammatory responses and adverse local tissue reactions in the close-to-stitching environment are often reported for biodegradable polymeric sutures currently used by the medical community. While bioabsorbable metals are predominantly investigated and tested for vascular stent or osteosynthesis applications, they also appear to possess adequate bio-compatibility, mechanical properties, and corrosion stability to replace biodegradable polymeric sutures. In this Review, biodegradable alloys made of iron, magnesium, and zinc are critically evaluated as potential materials for the manufacturing of soft and hard tissue sutures. In the case of soft tissue closing and stitching, these metals have to compete against currently available degradable polymers. In the case of hard tissue closing and stitching, biodegradable sternal wires could replace the permanent sutures made of stainless steel or titanium alloys. This Review discusses the specific materials and degradation properties required by all suture materials, summarizes current suture testing protocols and provides a well-grounded direction for the potential future development of biodegradable metal based sutures.

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Artifacts in spine magnetic resonance imaging due to different intervertebral test spacers: an in vitro evaluation of magnesium versus titanium and carbon-fiber-reinforced polymers as biomaterials

Cited by 34 publications

References 25 publications

Is the radiographic subsidence of stand-alone cages associated with adverse clinical outcomes after cervical spine fusion: an observational cohort study with 2-year follow-up outcome scoring

Is the radiographic subsidence of stand-alone cages associated with adverse clinical outcomes after cervical spine fusion: an observational cohort study with 2-year follow-up outcome scoring

Postoperative magnetic resonance imaging artifact with cobalt-chromium versus titanium spinal instrumentation

Recent Advances in Biodegradable Metals for Medical Sutures: A Critical Review

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