Endplate volumetric bone mineral density biomechanically matched interbody cage
Disc degenerative problems affect the aging population, globally, and interbody fusion is a crucial surgical treatment. The interbody cage is the critical implant in interbody fusion surgery; however, its subsidence risk becomes a remarkable clinical complication. Cage subsidence is caused due to a...
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| Format: | Article |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2022.1075574/full |
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| author | Yuanzhi Weng Yuanzhi Weng Mingyuan Di Mingyuan Di Tianchi Wu Tianchi Wu Xinlong Ma Qiang Yang Weijia William Lu Weijia William Lu Weijia William Lu |
| author_facet | Yuanzhi Weng Yuanzhi Weng Mingyuan Di Mingyuan Di Tianchi Wu Tianchi Wu Xinlong Ma Qiang Yang Weijia William Lu Weijia William Lu Weijia William Lu |
| author_sort | Yuanzhi Weng |
| collection | DOAJ |
| description | Disc degenerative problems affect the aging population, globally, and interbody fusion is a crucial surgical treatment. The interbody cage is the critical implant in interbody fusion surgery; however, its subsidence risk becomes a remarkable clinical complication. Cage subsidence is caused due to a mismatch of material properties between the bone and implant, specifically, the higher elastic modulus of the cage relative to that of the spinal segments, inducing subsidence. Our recent observation has demonstrated that endplate volumetric bone mineral density (EP-vBMD) measured through the greatest cortex-occupied 1.25-mm height region of interest, using automatic phantomless quantitative computed tomography scanning, could be an independent cage subsidence predictor and a tool for cage selection instruction. Porous design on the metallic cage is a trend in interbody fusion devices as it provides a solution to the subsidence problem. Moreover, the superior osseointegration effect of the metallic cage, like the titanium alloy cage, is retained. Patient-specific customization of porous metallic cages based on the greatest subsidence-related EP-vBMD may be a good modification for the cage design as it can achieve biomechanical matching with the contacting bone tissue. We proposed a novel perspective on porous metallic cages by customizing the elastic modulus of porous metallic cages by modifying its porosity according to endplate elastic modulus calculated from EP-vBMD. A three-grade porosity customization strategy was introduced, and direct porosity-modulus customization was also available depending on the patient’s or doctor’s discretion. |
| first_indexed | 2024-04-12T04:38:23Z |
| format | Article |
| id | doaj.art-d8965a649bb04b76999ae09484402c94 |
| institution | Directory Open Access Journal |
| issn | 2296-4185 |
| language | English |
| last_indexed | 2024-04-12T04:38:23Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-d8965a649bb04b76999ae09484402c942022-12-22T03:47:44ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852022-12-011010.3389/fbioe.2022.10755741075574Endplate volumetric bone mineral density biomechanically matched interbody cageYuanzhi Weng0Yuanzhi Weng1Mingyuan Di2Mingyuan Di3Tianchi Wu4Tianchi Wu5Xinlong Ma6Qiang Yang7Weijia William Lu8Weijia William Lu9Weijia William Lu10Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, ChinaGraduate School, Tianjin Medical University, Tianjin, ChinaDepartment of Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, ChinaDepartment of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, ChinaTianjin Hospital, Tianjin University, Tianjin, ChinaDepartment of Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, ChinaDepartment of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, ChinaResearch Center for Human Tissue and Organs Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences (CAS), Shenzhen, ChinaDisc degenerative problems affect the aging population, globally, and interbody fusion is a crucial surgical treatment. The interbody cage is the critical implant in interbody fusion surgery; however, its subsidence risk becomes a remarkable clinical complication. Cage subsidence is caused due to a mismatch of material properties between the bone and implant, specifically, the higher elastic modulus of the cage relative to that of the spinal segments, inducing subsidence. Our recent observation has demonstrated that endplate volumetric bone mineral density (EP-vBMD) measured through the greatest cortex-occupied 1.25-mm height region of interest, using automatic phantomless quantitative computed tomography scanning, could be an independent cage subsidence predictor and a tool for cage selection instruction. Porous design on the metallic cage is a trend in interbody fusion devices as it provides a solution to the subsidence problem. Moreover, the superior osseointegration effect of the metallic cage, like the titanium alloy cage, is retained. Patient-specific customization of porous metallic cages based on the greatest subsidence-related EP-vBMD may be a good modification for the cage design as it can achieve biomechanical matching with the contacting bone tissue. We proposed a novel perspective on porous metallic cages by customizing the elastic modulus of porous metallic cages by modifying its porosity according to endplate elastic modulus calculated from EP-vBMD. A three-grade porosity customization strategy was introduced, and direct porosity-modulus customization was also available depending on the patient’s or doctor’s discretion.https://www.frontiersin.org/articles/10.3389/fbioe.2022.1075574/fullinterbody fusioncage subsidenceendplateporous cage designpatient-specific customization implant |
| spellingShingle | Yuanzhi Weng Yuanzhi Weng Mingyuan Di Mingyuan Di Tianchi Wu Tianchi Wu Xinlong Ma Qiang Yang Weijia William Lu Weijia William Lu Weijia William Lu Endplate volumetric bone mineral density biomechanically matched interbody cage Frontiers in Bioengineering and Biotechnology interbody fusion cage subsidence endplate porous cage design patient-specific customization implant |
| title | Endplate volumetric bone mineral density biomechanically matched interbody cage |
| title_full | Endplate volumetric bone mineral density biomechanically matched interbody cage |
| title_fullStr | Endplate volumetric bone mineral density biomechanically matched interbody cage |
| title_full_unstemmed | Endplate volumetric bone mineral density biomechanically matched interbody cage |
| title_short | Endplate volumetric bone mineral density biomechanically matched interbody cage |
| title_sort | endplate volumetric bone mineral density biomechanically matched interbody cage |
| topic | interbody fusion cage subsidence endplate porous cage design patient-specific customization implant |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2022.1075574/full |
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