Nanocrystalline hydroxyapatite intervertebral cages induce fusion after anterior cervical discectomy and may be a safe alternative to PEEK or carbon fiber intervertebral cages

Timothy, Jake; Wilson, Jamie; Rice, Edward; Hall, Richard M.

doi:10.3109/02688697.2016.1173192

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…These results to some extent were in accordance with those of recent and related reports, as it had been shown that HA/PA composite has a positive effect on osteoblast adhesion, viability, and differentiation, thus influencing the bone cell responses as it comes in contact with HA/PA substrate [36–39]. …”

Section: Discussionsupporting

confidence: 92%

Fabrication and Characterization of Carbon Fiber-Reinforced Nano-Hydroxyapatite/Polyamide46 Biocomposite for Bone Substitute

et al. 2017

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BackgroundIdeal bone repair material should be of good biocompatibility and high bioactivity. Besides, their mechanical properties should be equivalent to those of natural bone. The objective of this study was to fabricate a novel biocomposite suitable for load-bearing bone defect repair.Material/MethodsA novel biocomposite composed of carbon fiber, hydroxyapatite and polyamide46 (CF/HA/PA46) was fabricated, and its mechanical performances and preliminary cell responses were evaluated to explore its feasibility for load-bearing bone defect repair.ResultsThe resultant CF/HA/PA46 biocomposite showed a bending strength of 159–223 MPa, a tensile strength of 127–199 MPa and a tensile modulus of 7.7–10.8 GPa, when the CF content was 5–20% (mass fraction) in biocomposite. The MG63 cells, showing an osteogenic phenotype, were well adhered and spread on the surface of the CF/HA/PA46 biocomposite. Moreover, the cells vitality and differentiation on the CF/HA/PA46 biocomposite surface were obviously increased during the culture time and there was no significant difference between the CF/HA/PA46 biocomposite and HA/PA (as control) at all the experimental time (P>0.05).ConclusionsThe addition of CF into HA/PA46 composite manifest improved the mechanical performances and showed favorable effects on biocompatibility of MG63 cells. The obtained biocomposite has high potential for bone repair in load-bearing sites.

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Section: Discussionsupporting

confidence: 92%

Fabrication and Characterization of Carbon Fiber-Reinforced Nano-Hydroxyapatite/Polyamide46 Biocomposite for Bone Substitute

et al. 2017

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“…Case series, described by Timothy et al, have demonstrated 100% bony fusion promotion after using HApN cages in ACDF without serious side effects. Moreover, HApN cages have shown a higher tolerance to torsion, shear, and compression forces when compared to other synthetic cages such as a PEEK [109].…”

Section: Nanohydroxyapatite Cagesmentioning

confidence: 99%

Hydroxyapatite Use in Spine Surgery—Molecular and Clinical Aspect

et al. 2022

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Hydroxyapatite possesses desirable properties as a scaffold in tissue engineering: it is biocompatible at a site of implantation, and it is degradable to non-toxic products. Moreover, its porosity enables infiltration of cells, nutrients and waste products. The outcome of hydroxyapatite implantation highly depends on the extent of the host immune response. Authors emphasise major roles of the chemical, morphological and physical properties of the surface of biomaterial used. A number of techniques have been applied to transform the theoretical osteoconductive features of HAp into spinal fusion systems—from integration of HAp with autograft to synthetic intervertebral implants. The most popular uses of HAp in spine surgery include implants (ACDF), bone grafts in posterolateral lumbar fusion and transpedicular screws coating. In the past, autologous bone graft has been used as an intervertebral cage in ACDF. Due to the morbidity related to autograft harvesting from the iliac bone, a synthetic cage with osteoconductive material such as hydroxyapatite seems to be a good alternative. Regarding posterolateral lumbar fusion, it requires the graft to induce new bone growth and reinforce fusion between the vertebrae. Hydroxyapatite formulations have shown good results in that field. Moreover, the HAp coating has proven to be an efficient method of increasing screw fixation strength. It can decrease the risk of complications such as screw loosening after pedicle screw fixation in osteoporotic patients. The purpose of this literature review is to describe in vivo reaction to HAp implants and to summarise its current application in spine surgery.

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“…Кейджі з нанокристалічного ГA (Nanoss ® -Cervical, Pioneer ® Surgical Technology, Inc., Marquette, MI), у якого розміри кристалів подібні до природної кістки, показали ефективність при проведенні передньої цервікальної дискектомії та спондилодезу (ACDF) [42].…”

Section: клінічні спостереженняunclassified

Calcium-phosphate ceramics in spine surgery: features of regeneration and use

Shapovalov

Dedukh

Shymon

2022

PJS

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The review is based on the analysis of 53 literature sources from PubMed, Google, Google Scholar, and Cochrane Library. Among the substitutes for autogenous bone grafts in spine surgery, ceramic biomaterials are the largest studied group, among which certain niche is occupied by calcium phosphate ceramics (CPCs). Hydroxylapatite, tricalcium phosphate and biphasic ceramics with all parts of hydroxylapatite and tricalcium phosphate are widely used in spine surgery. The advantage of using CPCs is their biocompatibility, osteoconductivity, osteoinductivity, osteoimmunomodulation and the ability to stimulate angiogenesis — the main components that ensure bone regeneration. In the given review, the peculiarities of regeneration in the interface “ceramic material — bone tissue” depending on the composition, surface structure, and crystallinity of the material are noted. The positive results of the experimental studies led to the use of CPCs in the clinic. CPCs with autogenous bone grafts are successfully used in posterior and posterolateral lumbar spondylodesis, which allows reducing significantly the volume of autologous bone. A new direction is the development of non-metallic combined cages, which are used to perform anterior cervical discectomy and spondylodesis. The composition of these cages includes various polymers in combination with CPCs and bone autogenous graft to ensure high-quality spondylodesis, reduce of stress-shielding and subsidence of the cage. A special approach requires the study of degradation and resorption by osteoclasts of various CPCs in order to control and synchronize the process of “resorption — bone formation”. Among the issues for the further research, the molecular mechanisms of osteoimunomodulation and factors that stimulate osseointegration and osteoinduction in the management of reparative osteogenesis should be further explored.

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Nanocrystalline hydroxyapatite intervertebral cages induce fusion after anterior cervical discectomy and may be a safe alternative to PEEK or carbon fiber intervertebral cages

Abstract: This series provides evidence that nHA intervertebral cages can successfully promote fusion after ACDF and may provide an alternative to carbon fiber and PEEK cages.

Cited by 3 publications

References 23 publications

Fabrication and Characterization of Carbon Fiber-Reinforced Nano-Hydroxyapatite/Polyamide46 Biocomposite for Bone Substitute

Fabrication and Characterization of Carbon Fiber-Reinforced Nano-Hydroxyapatite/Polyamide46 Biocomposite for Bone Substitute

Hydroxyapatite Use in Spine Surgery—Molecular and Clinical Aspect

Calcium-phosphate ceramics in spine surgery: features of regeneration and use

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