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Impact of mechanical stability on the progress of bone ongrowth on the frame surfaces of a titanium-coated PEEK cage and a 3D porous titanium alloy cage: in vivo analysis using CT color mapping

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Abstract

Purpose

To determine the impact of mechanical stability on the progress of bone ongrowth on the frame surfaces of a titanium-coated polyether ether ketone (TCP) cage and a three-dimensional porous titanium alloy (PTA) cage following posterior lumbar interbody fusion (PLIF) until 1 year postoperatively.

Methods

A total of 59 patients who underwent one- or two-level PLIF for degenerative lumbar disorders since March 2015 were enrolled. Bone ongrowth of all cage frame surfaces (four surfaces per cage: TCP, 288 surfaces and PTA, 284 surfaces) was graded by 6-month and 1-year postoperative computed tomography color mapping (grade 0, 0‒25% of bone ongrowth; grade 1, 26‒50%; grade 2, 51‒75%; and grade 3, 76‒100%).

Results

Bone ongrowth (≥ grade 1) was observed on 58.0% and 69.0% of the surfaces of TCP and PTA cages 6 months postoperatively and on 63.5% and 75.0% of those 1 year postoperatively, respectively. In the TCP cages, bone ongrowth grade increased from 6 months to 1 year postoperatively only in the union segments (median, 1 [interquartile range, IQR, 0–2] to 1 [IQR, 0–3], p = 0.006). By contrast, in the PTA cages, it increased at 6 months postoperatively in the union (1 [IQR, 1–2] to 2 [IQR, 1–3], p = 0.003) and non-union (0.5 [IQR, 0–2] to 1 [IQR, 0–2.75], p = 0.002) segments.

Conclusion

Early postoperative mechanical stability has a positive impact on the progress of bone ongrowth on both the TCP and PTA cage frame surfaces after PLIF.

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Availability of data and materials

The datasets generated during the current study are available from the corresponding author on reasonable request.

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Acknowledgement

The authors want to thank Dr. Yuya Kanie (Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan) for his valuable help in the statistical part of this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Takahiro Makino, Shota Takaneka, Yusuke Sakai, Hideki Yoshikawa & Takashi Kaito

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  1. Takahiro Makino
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  2. Shota Takaneka
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  3. Yusuke Sakai
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  4. Hideki Yoshikawa
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  5. Takashi Kaito
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Correspondence to Takashi Kaito.

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All procedures performed were in accordance with the HELSINKI declaration 1964. This research has been approved by the IRB of the authors’ affiliated institutions.

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The research protocol was approved and publicized by the authors’ affiliated institution, and the patients were given the right to opt out of the study.

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Makino, T., Takaneka, S., Sakai, Y. et al. Impact of mechanical stability on the progress of bone ongrowth on the frame surfaces of a titanium-coated PEEK cage and a 3D porous titanium alloy cage: in vivo analysis using CT color mapping. Eur Spine J 30, 1303–1313 (2021). https://doi.org/10.1007/s00586-020-06673-4

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  • DOI: https://doi.org/10.1007/s00586-020-06673-4

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