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Comparison of Osseointegration in Different Intravertebral Fixators

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Abstract

Purpose

Percutaneous minimally invasive spinal surgery is performed to manage vertebral compression fractures. The novel modular spine block (MSB) is a spinal fixator designed to provide cementless intravertebral fixation. This study tested the rate of new bone formation in a porcine model following MSB fixation.

Methods

A total of 24 MSBs were implanted in four pigs that served as porcine animal models: solid MSB designated as MSB-0, perforated MSB as MSB-1, hollow MSB as MSB-2, porous 3D-printed MSB as MSB-3. Commercially available intravertebral expandable pillars (IVEP) were also implanted, to serve as a comparison with the MSBs. All pigs underwent X-ray imaging, computed tomography (CT), micro-CT, and histomorphometry. The bone volume fraction (bone volume/tissue volume, BV/TV), bone surface density (bone surface area/tissue volume, BS/TV), trabecular bone thickness (TBT), trabecular bone number (TBN), and trabecular bone separation (TBS) were evaluated.

Results

All fixators were securely implanted without any major complications. Adequate alignment of the implants was confirmed radiologically. Marked bone growth was observed on micro-CT and histomorphometry. The average results of BV/TV, BS/TV, TBT, and TBN were the highest in the MSB-2 cases, whereas the values of TBS were the lowest. No statistically significant differences were found between the various intravertebral fixators used.

Conclusions

These findings suggest that MSBs have a similar positive effect on osseointegration as other commercially available cementless intravertebral device. Since these data were obtained from porcine models, further clinical research is required to confirm the reproducibility of these data in humans.

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Acknowledgements

This study was approved by National Taiwan University Hospital. The authors wish to thank all the members who participated in this study.

Author information

Authors and Affiliations

  1. Department of Biomedical Engineering, National Taiwan University, No1, Sec. 1, Jen - Ai Rd., Taipei, 100233, Taiwan (R.O.C.)

    Jui-Yang Hsieh & Yi-You Huang

  2. Department of Orthopedic Surgery, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, 100225, Taiwan (R.O.C.)

    Jui-Yang Hsieh, Jyh-Horng Wang & Po-Quang Chen

  3. Department of Orthopedic Surgery, National Taiwan University Hospital **shan Branch, No.7, Yulu Rd., Wuhu Village, **shan Dist., Taipei, 20844, Taiwan (R.O.C.)

    Jui-Yang Hsieh

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Contributions

Y-YH designed the study. J-YH participated in the conception, acquisition, analysis and interpretation of the data, drafting, and final preparation of the manuscript. J-HW and P-QC revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yi-You Huang.

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Conflict of interest

The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

Ethical Approval

The experimental protocol and surgical procedures were conducted with the approval of the Institutional Animal Care and Use Committee of Pig model Animal Technology Co., Ltd. (Approval No. PIG-107012).

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All authors will either grant the Publisher an exclusive license to publish the article.

Supplementary Information

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40846_2022_698_MOESM1_ESM.jpg

Supplementary file1 (JPG 179 kb)—Supplemental Figure 1—Procedure of MSB fixation (from left to right): transpedicular insertion of the first MSB segment, guided by a template plug, expansion by a thin tamper, expansion by a thick tamper, and second MSB segment fixation.

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Hsieh, JY., Wang, JH., Chen, PQ. et al. Comparison of Osseointegration in Different Intravertebral Fixators. J. Med. Biol. Eng. 42, 196–203 (2022). https://doi.org/10.1007/s40846-022-00698-4

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  • DOI: https://doi.org/10.1007/s40846-022-00698-4

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