| Radiographic, histologic, and chemical evaluation of bioresorbable 70/30 poly-L-lactide-CO-D, L-lactide interbody fusion cages in a goat model. | |
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MedLine Citation:
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PMID: 16778688 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: A study of lumbar interbody fusion using polylactic acid-based bioresorbable fusion cages in a goat model. OBJECTIVE: To evaluate the effect of polylactic acid polymer composition, and internal stabilization on the rate and quality of interbody fusion. SUMMARY OF BACKGROUND DATA: A spinal cage should provide an appropriate biomechanical environment to facilitate interbody fusion. Previous studies have shown that bioresorbable polylactic acid-based cages can provide adequate stability for spinal fusion. However, at present and to our knowledge, the best bioresorbable materials, optimal cage stiffness, and desired period over which the cage should biodegrade are unknown. METHODS: Interbody fusions were performed at L3-L4 level in 35 skeletally mature Dutch milk goats. Titanium and poly-L-lactide-CO-D,L-lactide (PLDLLA) cages were implanted at random as stand-alone cages. In addition, PLDLLA cages were implanted with anterior fixation. The goats were euthanized at 3, 6, or 12 months. Radiographic, magnetic resonance imaging, histologic, and histomorphometric analyses were performed on retrieved segments. Chemical analysis was used to assess degradation of the retrieved PLDLLA cages. Beforehand, chemical and mechanical degradation of the PLDLLA cages were assessed in vitro. RESULTS: At 3 months, bone graft was almost completely remodeled. Endochondral bone formation was observed in all specimens. At 6 months, 50% of the PLDLLA stand-alone cages and 83% of the PLDLLA anterior fixation cages were fused. At 12 months, 38% of the PLDLLA stand-alone and 83% of the titanium cages realized fusion. A very mild and dispersed foreign body reaction was seen in all PLDLLA specimens. E-beam sterilized PLDLLA cages degraded more rapidly in vivo as compared to both, PLDLLA cages in vitro, and ethylene oxide sterilized poly-L-lactic acid cages in vivo. CONCLUSIONS: Within the 3-6-month period, PLDLLA stand-alone cages provided insufficient mechanical stability, which manifested as cracking and deformation of the cages and lower fusion rates. This result implies that within this time, additional stabilization is required; supplemental internal fixation proved sufficient to obtain successful fusion. In all cases, only a mild host response was seen, indicating good biocompatibility. |
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Authors:
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Matthijs R Krijnen; Margriet G Mullender; Theo H Smit; Vincent Everts; Paul I J M Wuisman |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Spine Volume: 31 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2006 Jun |
Date Detail:
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Created Date: 2006-06-16 Completed Date: 2006-08-03 Revised Date: 2009-07-09 |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: 1559-67 Citation Subset: IM |
Affiliation:
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Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Absorbable Implants* Animals Biocompatible Materials Bone Remodeling Disinfection Equipment Failure Female Foreign-Body Reaction / chemically induced Goats Internal Fixators* Lumbar Vertebrae / pathology, physiopathology, radiography, surgery* Magnetic Resonance Imaging Polyesters* / adverse effects Spinal Fusion / instrumentation* Time Factors Titanium |
| Chemical | |
Reg. No./Substance:
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0/Biocompatible Materials; 0/Polyesters; 26969-66-4/poly(lactide); 7440-32-6/Titanium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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