Biomaterials for Interbody Fusion in Bone Tissue Engineering

Abstract

In recent years, interbody fusion cages have played an important role in interbody fusion surgery for treating diseases like disc protrusion and spondylolisthesis. However, traditional cages cannot achieve satisfactory results due to their unreasonable design, poor material biocompatibility, and induced osteogenesis ability, limiting their application. There are currently 3 ways to improve the fusion effect, as follows. First, the interbody fusion cage is designed to facilitate bone ingrowth through the preliminary design. Second, choose interbody fusion cages made of different materials to meet the variable needs of interbody fusion. Finally, complete post-processing steps, such as coating the designed cage, to achieve a suitable osseointegration microstructure, and add other bioactive materials to achieve the most suitable biological microenvironment of bone tissue and improve the fusion effect. The focus of this review is on the design methods of interbody fusion cages, a comparison of the advantages and disadvantages of various materials, the influence of post-processing techniques and additional materials on interbody fusion, and the prospects for the future development of interbody fusion cages.

Synthetic Interbody Devices and Traditional Bone Graft Are Associated With a Similar Rate of Surgical Complications After 1-2 Level Anterior Cervical Discectomy and Fusions

“…However, titanium is less elastic than other materials. 12 In contrast, PEEK cages are made to be elastic to redistribute the axial skeletal load and are bio-inert, which reduces the risk of infection but also may lower osteogenic potential. 13 Krause et al 9 and Teton et al 14 showed a 5 and 6-fold increase in risk of pseudarthrosis with PEEK cages compared with allograft and D'Antonio et al 15 showed that PEEK cage implantation was independently associated with postoperative pseudarthrosis.…”

“…Titanium provides structural support, maintains disc space height, and can develop a layer of titanium dioxide, which promotes osteogenesis. However, titanium is less elastic than other materials 12 . In contrast, PEEK cages are made to be elastic to redistribute the axial skeletal load and are bio-inert, which reduces the risk of infection but also may lower osteogenic potential 13 .…”

Harnessing osteoimmunity to treat peri-implant inflammatory osteolysis

“…156 In addition to conductive biomaterials (carbon-based nanomaterials, metallic conductive materials, and conducting polymers) that can be stimulated by exogenous power sources, nanogenerators, such as piezoelectric materials, can also rely on mechanical force conduction. Similarly, materials with superior optoelectronic properties like Mxenes can be stimulated by light of different wavelengths and penetration depths, 153 which are expected to produce time-sequential modulations that can intervene in the functioning of tissues and cells.…”

Anatomical Brushite-Coated Mg–Nd–Zn–Zr Alloy Cage Promotes Cervical Fusion: One-Year Results in Goats

“…3,4 Currently, the most commonly used interbody fusion cage for ACDF is made of nonabsorbable materials such as titanium alloy and polyether ether ketone (PEEK). 5 However, nonresorbable cages only provide intervertebral support without degradability and osteogenesis induction. 6,7 In recent years, research on absorbable fusion cages has emerged, and many studies have examined absorbable cages made of polymers and bioceramics.…”

“…Anterior cervical decompression and fusion (ACDF) is the primary option for the surgical treatment of CDD . ACDF was performed by removing part of the disc tissue and inserting a fusion device, thus providing decompression and fixation. , Currently, the most commonly used interbody fusion cage for ACDF is made of nonabsorbable materials such as titanium alloy and polyether ether ketone (PEEK) . However, nonresorbable cages only provide intervertebral support without degradability and osteogenesis induction. , …”