Evaluation of 70/30 poly (L-lactide-co-D,L-lactide) for use as a resorbable interbody fusion cage.
OBJECTIVE
Titanium lumbar interbody spinal fusion devices are reported to be 90% effective in cases requiring single-level lumbar interbody arthrodesis, although radiographic determination of fusion has been debated.


METHODS
Using blinded radiographic, biomechanical, histological, and statistical measures, researchers in the present study evaluated a radiolucent 70/30 poly(L-lactide-co-D,L-lactide) interbody fusion device packed with autograft or recombinant human bone morphogenetic protein-2 on a collagen sponge in 25 sheep at 3, 6, 12, 18, and 24 months. A trend of increased fusion stiffness, radiographic fusion, and histologically confirmed fusion was demonstrated at 3 months to 24 months postimplantation. Device degradation was associated with a mild to moderate chronic inflammatory response at all postoperative sacrifice times.


CONCLUSIONS
Use of this material in interbody fusion may be a viable alternative to metals.
Toth
Jeffrey M
JM
Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, USA.
Estes
Bradley T
BT
Wang
Mei
M
Seim
Howard B
HB
Scifert
Jeffrey L
JL
Turner
A Simon
AS
Cornwall
G Bryan
GB
D020341:Absorbable Implants; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001696:Biomechanical Phenomena; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000494:pharmacology; D015194:Diffusion Chambers, Culture / Q000295:instrumentation; D004195:Disease Models, Animal; D005069:Evaluation Studies as Topic; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D011091:Polyesters / Q000627:therapeutic use*; D011859:Radiography; D011994:Recombinant Proteins; D020127:Recovery of Function / Q000502:physiology; D012756:Sheep; D013123:Spinal Fusion / Q000295:instrumentation*; D013124:Spinal Injuries / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016212:Transforming Growth Factor beta
C525718:BMP2 protein, human; D001672:Biocompatible Materials; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D011091:Polyesters; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2; C033616:poly(lactide)