Cervical subtotal discectomy prosthesis validated in non-human primate model: A novel artificial cervical disc replacement concept?

Objective: To evaluate the biological function of cervical subtotal discectomy prosthesis (CSDP) implantation in a non-human primate model.Methods: A CSDP was tested for cytocompatibility and osseointegration capacity before implantation in non-human primates. Subsequently, the CSDP was improved bas...

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Main Authors: Yang Liu, Jin Wo, Haoran Zhu, Zhonghai Huang, Pan Zhou, Jinpei Yang, Shuai Zheng, Libing Zhou, Fengjin Tan, Guodong Sun, Zhizhong Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-10-01
Series:Frontiers in Bioengineering and Biotechnology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fbioe.2022.997877/full
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author Yang Liu
Jin Wo
Jin Wo
Haoran Zhu
Zhonghai Huang
Zhonghai Huang
Pan Zhou
Jinpei Yang
Shuai Zheng
Libing Zhou
Libing Zhou
Fengjin Tan
Guodong Sun
Zhizhong Li
author_facet Yang Liu
Jin Wo
Jin Wo
Haoran Zhu
Zhonghai Huang
Zhonghai Huang
Pan Zhou
Jinpei Yang
Shuai Zheng
Libing Zhou
Libing Zhou
Fengjin Tan
Guodong Sun
Zhizhong Li
author_sort Yang Liu
collection DOAJ
description Objective: To evaluate the biological function of cervical subtotal discectomy prosthesis (CSDP) implantation in a non-human primate model.Methods: A CSDP was tested for cytocompatibility and osseointegration capacity before implantation in non-human primates. Subsequently, the CSDP was improved based on three-dimensional CT measurements of the non-human primate cervical spine. Eight cynomolgus monkeys were selected for removal of the intervertebral disc and lower endplate of the C5/6 segment to complete the model construction for CSDP implantation. In 18-month follow-up, physiological indices, radiology, and kinematics were assessed to estimate the biological function of the CSDP in non-human primates, including biosafety, osseointegration, and biomechanics.Results: Co-cultured with the CSDP constituent titanium alloy (Ti6Al4V-AO), the mouse embryo osteoblast precursor cell MC3T3-E1 obtained extended adhesion, remarkable viability status, and cell proliferation. After implantation in the mouse femur for 28 days, the surface of Ti6Al4V-AO was covered by a large amount of new cancellous bone, which formed further connections with the femur cortical bone, and no toxicity was detected by blood physiology indices or histopathology. After completing implantation in primate models, no infection or osteolysis was observed, nor was any subsidence or displacement of the CSDP observed in CT scans in the 18-month follow-up. In particular, the interior of the cervical vertebra fixation structure was gradually filled with new trabecular bone, and the CSDP had achieved fixation and bony fusion in the vertebral body at 1 year post-operation. Meanwhile, no signs of inflammation, spinal cord compression, adjacent segment degeneration, or force line changes were observed in subsequent MRI observations. Moreover, there were no pathological changes of the joint trajectory, joint motion range, stride length, or the stance phase ratio revealed in the kinematics analysis at 3, 6, 12, or 18 months after CSDP implantation.Conclusion: We successfully designed a new cervical subtotal discectomy prosthesis and constructed an excellent non-human primate implantation model for the evaluation of subtotal disc replacement arthroplasty. Furthermore, we demonstrated that CSDP had outstanding safety, osseointegration capacity, and biomechanical stability in a non-human primate model, which might be a new choice in the treatment of cervical disc diseases and potentially change future outcomes of degenerative cervical diseases.
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spelling doaj.art-50aea9d8a9324885aea7219266928a532022-12-22T03:31:15ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852022-10-011010.3389/fbioe.2022.997877997877Cervical subtotal discectomy prosthesis validated in non-human primate model: A novel artificial cervical disc replacement concept?Yang Liu0Jin Wo1Jin Wo2Haoran Zhu3Zhonghai Huang4Zhonghai Huang5Pan Zhou6Jinpei Yang7Shuai Zheng8Libing Zhou9Libing Zhou10Fengjin Tan11Guodong Sun12Zhizhong Li13Department of Orthopedics, First Affiliated Hospital and Fifth Affiliated Hospital, Jinan University, Guangzhou, ChinaDepartment of Orthopedics, First Affiliated Hospital and Fifth Affiliated Hospital, Jinan University, Guangzhou, ChinaGuangdong-Hongkong-Macau Institute of CNS Regeneration, Ministry of Education CNS Regeneration Collaborative Joint Laboratory, Jinan University, Guangzhou, ChinaDepartment of Orthopedics, First Affiliated Hospital and Fifth Affiliated Hospital, Jinan University, Guangzhou, ChinaDepartment of Orthopedics, First Affiliated Hospital and Fifth Affiliated Hospital, Jinan University, Guangzhou, ChinaGuangdong-Hongkong-Macau Institute of CNS Regeneration, Ministry of Education CNS Regeneration Collaborative Joint Laboratory, Jinan University, Guangzhou, ChinaDepartment of Orthopedics, First Affiliated Hospital and Fifth Affiliated Hospital, Jinan University, Guangzhou, ChinaHuizhou Third People’s Hospital, Guangzhou Medical University, Huizhou, ChinaDepartment of Orthopedics, First Affiliated Hospital and Fifth Affiliated Hospital, Jinan University, Guangzhou, ChinaDepartment of Orthopedics, First Affiliated Hospital and Fifth Affiliated Hospital, Jinan University, Guangzhou, ChinaGuangdong-Hongkong-Macau Institute of CNS Regeneration, Ministry of Education CNS Regeneration Collaborative Joint Laboratory, Jinan University, Guangzhou, ChinaOrthopedics and Traumatology, Yantai Hospital of Traditional Chinese Medicine, Yantai, ChinaDepartment of Orthopedics, First Affiliated Hospital and Fifth Affiliated Hospital, Jinan University, Guangzhou, ChinaDepartment of Orthopedics, First Affiliated Hospital and Fifth Affiliated Hospital, Jinan University, Guangzhou, ChinaObjective: To evaluate the biological function of cervical subtotal discectomy prosthesis (CSDP) implantation in a non-human primate model.Methods: A CSDP was tested for cytocompatibility and osseointegration capacity before implantation in non-human primates. Subsequently, the CSDP was improved based on three-dimensional CT measurements of the non-human primate cervical spine. Eight cynomolgus monkeys were selected for removal of the intervertebral disc and lower endplate of the C5/6 segment to complete the model construction for CSDP implantation. In 18-month follow-up, physiological indices, radiology, and kinematics were assessed to estimate the biological function of the CSDP in non-human primates, including biosafety, osseointegration, and biomechanics.Results: Co-cultured with the CSDP constituent titanium alloy (Ti6Al4V-AO), the mouse embryo osteoblast precursor cell MC3T3-E1 obtained extended adhesion, remarkable viability status, and cell proliferation. After implantation in the mouse femur for 28 days, the surface of Ti6Al4V-AO was covered by a large amount of new cancellous bone, which formed further connections with the femur cortical bone, and no toxicity was detected by blood physiology indices or histopathology. After completing implantation in primate models, no infection or osteolysis was observed, nor was any subsidence or displacement of the CSDP observed in CT scans in the 18-month follow-up. In particular, the interior of the cervical vertebra fixation structure was gradually filled with new trabecular bone, and the CSDP had achieved fixation and bony fusion in the vertebral body at 1 year post-operation. Meanwhile, no signs of inflammation, spinal cord compression, adjacent segment degeneration, or force line changes were observed in subsequent MRI observations. Moreover, there were no pathological changes of the joint trajectory, joint motion range, stride length, or the stance phase ratio revealed in the kinematics analysis at 3, 6, 12, or 18 months after CSDP implantation.Conclusion: We successfully designed a new cervical subtotal discectomy prosthesis and constructed an excellent non-human primate implantation model for the evaluation of subtotal disc replacement arthroplasty. Furthermore, we demonstrated that CSDP had outstanding safety, osseointegration capacity, and biomechanical stability in a non-human primate model, which might be a new choice in the treatment of cervical disc diseases and potentially change future outcomes of degenerative cervical diseases.https://www.frontiersin.org/articles/10.3389/fbioe.2022.997877/fullcervical artificial disc replacementcervical arthroplastyartificial discprosthesisprimate modelbiomechanics
spellingShingle Yang Liu
Jin Wo
Jin Wo
Haoran Zhu
Zhonghai Huang
Zhonghai Huang
Pan Zhou
Jinpei Yang
Shuai Zheng
Libing Zhou
Libing Zhou
Fengjin Tan
Guodong Sun
Zhizhong Li
Cervical subtotal discectomy prosthesis validated in non-human primate model: A novel artificial cervical disc replacement concept?
Frontiers in Bioengineering and Biotechnology
cervical artificial disc replacement
cervical arthroplasty
artificial disc
prosthesis
primate model
biomechanics
title Cervical subtotal discectomy prosthesis validated in non-human primate model: A novel artificial cervical disc replacement concept?
title_full Cervical subtotal discectomy prosthesis validated in non-human primate model: A novel artificial cervical disc replacement concept?
title_fullStr Cervical subtotal discectomy prosthesis validated in non-human primate model: A novel artificial cervical disc replacement concept?
title_full_unstemmed Cervical subtotal discectomy prosthesis validated in non-human primate model: A novel artificial cervical disc replacement concept?
title_short Cervical subtotal discectomy prosthesis validated in non-human primate model: A novel artificial cervical disc replacement concept?
title_sort cervical subtotal discectomy prosthesis validated in non human primate model a novel artificial cervical disc replacement concept
topic cervical artificial disc replacement
cervical arthroplasty
artificial disc
prosthesis
primate model
biomechanics
url https://www.frontiersin.org/articles/10.3389/fbioe.2022.997877/full
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