Trabecular Bone Remodeling After Posterior Lumbar Interbody Fusion: Comparison of Three-Dimensional Porous Tantalum and Titanium-Coated Polyetheretherketone Interbody Cages

Segi, Naoki; Nakashima, Hiroaki; Shinjo, Ryuichi; Kagami, Yujiro; Machino, Masaaki; Ito, Sadayuki; Ouchida, Jun; Morishita, Kazuaki; Oishi, Ryotaro; Yamauchi, Ippei; Imagama, Shiro

doi:10.1177/21925682231170613

Cited by 4 publications

(1 citation statement)

References 40 publications

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“…Thus, PTCs could be a viable alternative to autologous bone grafting, potentially avoiding donor-site morbidity. Furthermore, in posterior LIF (PLIF), PTCs show promising results in early bone integration and stability, as indicated by computed tomography (CT) findings of trabecular bone remodeling and lower incidences of vertebral endplate cyst formation compared with Ti-coated PEEK cages [ 49 ]. Collectively, these studies have suggested that PTCs can achieve immediate stabilization, facilitate bone fusion, and improve long-term outcomes in spinal surgery.…”

Section: Evolution Of Cage Materials In Lumbar Interbody Fusionmentioning

confidence: 99%

Innovative Developments in Lumbar Interbody Cage Materials and Design: A Comprehensive Narrative Review

Chang,

Kang,

Cho

2024

Asian Spine J

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This narrative review comprehensively examines the evolution and current state of the interbody cage technology for lumbar interbody fusion (LIF). This review highlights the biomechanical and clinical implications of transition from traditional static cage designs to advanced expandable variants for spinal surgery. The review begins by exploring the early developments in cage materials, highlighting the roles of titanium and polyetheretherketone in advancing LIF techniques. It discusses the strengths and limitations of these materials, leading to innovations in surface modifications and the introduction of novel materials, such as tantalum, as an alternative material. Advancements in three-dimensional printing and surface modification technologies form a significant part of this review, emphasizing the role of these technologies in enhancing the biomechanical compatibility and osseointegration of interbody cages. This review also explores the rise of biodegradable and composite materials such as polylactic acid and polycaprolactone, addressing their potential to mitigate long-term implant-related complications. A critical evaluation of static and expandable cages is presented in this review, including their respective clinical and radiological outcomes. While static cages have been a mainstay of LIF, expandable cages are noted for their ability to adapt to the patient's anatomy, potentially reducing complications such as cage subsidence. However, this review highlights the ongoing debate and the lack of conclusive evidence regarding the superiority of either cage type in terms of clinical outcomes. Finally, this review proposes future directions for cage technology, focusing on the integration of bioactive substances and multifunctional coatings and development of patient-specific implants. These advancements aim to further enhance the efficacy, safety, and personalized approach of spinal fusion surgeries. This review offers a nuanced understanding of the evolving landscape of cage technology in LIF and provides insights into the current practices and future possibilities in spinal surgery.

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Section: Evolution Of Cage Materials In Lumbar Interbody Fusionmentioning

confidence: 99%

Innovative Developments in Lumbar Interbody Cage Materials and Design: A Comprehensive Narrative Review

Chang,

Kang,

Cho

2024

Asian Spine J

View full text Add to dashboard Cite

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Comparison of Lumbar Interbody Fusion with 3D-Printed Porous Titanium Cage Versus Polyetheretherketone Cage in Treating Lumbar Degenerative Disease: A Systematic Review and Meta-Analysis

Duan,

Feng,

et al. 2024

World Neurosurgery

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Reduced Subsidence With PEEK-Titanium Composite Versus 3D Titanium Cages in a Retrospective, Self-Controlled Study in Transforaminal Lumbar Interbody Fusion

Chahlavi

2024

Global Spine Journal

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Study Design Retrospective Study. Objectives To compare subsidence and radiographic fusion rates of titanium-surface polyetheretherketone (PEEK-Ti) and 3D-Titanium (3D-Ti) cages, implanted within the same patient concurrently, during multi-level transforaminal lumbar interbody fusions (TLIF). Methods Forty-eight patients were treated with both PEEK-Ti and 3D-Ti cages during 2- or 3-level TLIF and instrumented posterolateral fusion (108 spinal levels in all). Equivalent bone graft material was implanted within each patient. Radiographic analysis of CT and/or X-ray imaging was performed retrospectively for each spinal level throughout 12-month follow-up period. Fusion was defined as bridging trabecular bone and subsidence was incursion into one/both vertebral bodies >20% cage height. Outcomes were analyzed with Fisher’s exact test. Results At 6-months post-operative follow-up, incidence of subsidence was significantly lower for PEEK-Ti cages, with 4.8% subsidence, compared to a 27.9% subsidence rate for 3D-Ti cages ( P = .007). Fusion rates were comparable at 100% for PEEK-Ti and 95.5% for 3D-Ti. Results at 12-months showed similar but not statistically significant trends of less subsidence with PEEK-Ti than 3D-Ti cages (14.3% PEEK-Ti, 37.5% 3D-Ti), and similar fusion rates of 100% for PEEK-Ti and 91.7% for 3D-Ti. Thirty-nine out of 48 total patients were available for follow-up at 6 months and 20 patients at 12 months. CT availability at 6 and 12-months was 100% and 90%, respectively. Conclusions A significantly lower subsidence rate was associated with a PEEK-Ti cage, compared to 3D-Ti, 6 months after TLIF. Results may not be generalized across technologies due to differences in cage designs; additional research studies are warranted.

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Trabecular Bone Remodeling After Posterior Lumbar Interbody Fusion: Comparison of Three-Dimensional Porous Tantalum and Titanium-Coated Polyetheretherketone Interbody Cages

Cited by 4 publications

References 40 publications

Innovative Developments in Lumbar Interbody Cage Materials and Design: A Comprehensive Narrative Review

Innovative Developments in Lumbar Interbody Cage Materials and Design: A Comprehensive Narrative Review

Comparison of Lumbar Interbody Fusion with 3D-Printed Porous Titanium Cage Versus Polyetheretherketone Cage in Treating Lumbar Degenerative Disease: A Systematic Review and Meta-Analysis

Reduced Subsidence With PEEK-Titanium Composite Versus 3D Titanium Cages in a Retrospective, Self-Controlled Study in Transforaminal Lumbar Interbody Fusion

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