Porous tantalum in spinal surgery: an overview

Abstract

Porous tantalum is an open-cell metal structure that approximates the appearance of human cancellous bone. It has a low modulus of elasticity, close to that of subchondral and cancellous bones, leading to better load transfer and minimizing the stress-shielding phenomenon. Its coefficient of friction is one of the highest among biomaterials, allowing for sufficient primary stabilization of implants, possibly even without screw fixation. Different fusion rates have been achieved in anterior cervical fusion, which lead to contradictory views among spine surgeons. However, in the lumbar spine, trabecular metal has been demonstrated to be effective in obtaining fusion and improving patient outcomes after anterior as well as posterior lumbar interbody fusion.

Anterior Cervical Fusion with Stand-alone Trabecular Metal Cages to Treat Cervical Myelopathy Caused by Degenerative Disk Disease. Observations in 88 Cases with Minimum 12-month Follow-up

“…Experimental studies demonstrated that the EM of TM corresponds to a mixture of bone obtained from human subchondral and cancellous bone, 13,53 leading to better load transfer and minimizing the stress-shielding phenomenon. Also for these reasons TM cages appear highly suitable for ACF after cervical microdiskectomy.…”

The use of porous tantalum cages in the treatment of unremitting spondylodiscitis: a case report

“…Sagomonyants et al have shown that porous tantalum stimulates proliferation and osteogenesis of osteoblasts (12). Due to its unique properties, it has been successfully used in cervical and in a variety of lumbar spine procedures as a sound interbody device (13).…”

Novel use of a trabecular metal spacer in the treatment of a long-standing ulnar fracture non-union

“…In hip surgery, TM implants (without using bone graft) have been shown to be no less inferior to traditional implants when managing acetabular defects and pelvic discontinuity during acetabular revision arthroplasty 21. In spine surgery, TM implants without graft have shown satisfactory fusion rates and clinical outcomes in both cervical corpectomy and lumbar interbody fusion surgery 22. In knee surgery, TM implants have shown comparable results in total knee arthroplasty when compared with cemented implants, particularly in the young and active population 23.…”