Journal List > J Korean Soc Spine Surg > v.12(1) > 1035647

Lee, Park, Song, Ryu, Seo, Hong, Kim, Chang, and Lee: Evaluation of Osteosynthesis in CaO-SiO2-P2 O5-B2 O3 Glass-ceramics by Posterolateral Fusion of Rabbit Lumbar vertebrae

Abstract

Study Design

A comparative in vivo study between ceramics with different compositions.

Objectives

To compare the biodegradation and osteoconduction properties of CaO- SiO2- P2 O5- B2 O3 glass- ceramics and Cerabone- A W.

Summary of Literature Review

Bioglass ceramics can be used as bone graft substitutes. However, no study has been undertak-en to investigate the possibility of CaO- SiO2- P2 O5- B2 O3 glass- ceramics as a bone graft substitute.

Materials and Methods

Porous CSPB2 implants (44.07% CaO, 40.28% SiO2, 8.1% P2 O5 and 5.0% B 2 O3), porous CSPB3 implants (43.76% CaO, 43.41% SiO2, 4.05% P2O5 and 7.5% B2O3) and porous Cerabone- AW were prepared by the polymer sponge method. Single- level posterolateral spinal fusions were performed on sixty New Zealand white male rabbits. The animals were divided into four groups (9 of autograft, 17 per 3 kind of porous implant group) according to the implant material used: autograft, CSPB2, CSPB3 and Cerabone- A W. Radiographs were performed every two weeks. All animals were sacrificed 12 weeks after surgery. Manual palpation and uniaxial tensile strength were determined. The proportion of the area occupied by the ceramics in the final compared to the initial radiographs was calculated. Decalcified and undecalcified histological sections were evaluated by light microscopy.

Results

Fifty one rabbits were evaluated. The union rates were 100 (9 out of 9), 80 (8 out of 8), 81.1(9 out of 11) and 90.9% (10 out of 11) in the autograft, Cerabone- AW, CSPB2 and CSPB3 groups, respectively. The proportion of the area occupied by Cerabone- A W (9 0.8%± 14.0) was significantly higher than for CSPB2 (73.1%± 11.5) and CSPB3 (73.5%± 10.0)(p=0.0011). The mean values of the tensile strengths of Cerabone- AW (214. ± 57.3N), CSPB2 (214.± 57.3 N) and CSPB3 (217± 70.1N) were not significantly different (p>0.05).

Conclusion

CSPB2 and CSPB3 had similar tensile strengths and fusion rates of the fusion masses as those of Cerabone- A W; however, they degraded more rapidly than Cerabone- A W. These findings suggest that CSPB2 and CSPB3 grafts can be used as a more ideal new bone graft substitutes than Cerabone- A W.

REFERENCES

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Figures and Tables%

Fig. 1.
The calculation process using Image-Pro Plus (Media Cybernetics, USA). Left: Immediate postoperative radiograph, Right: postoperative 12 weeks radiograph.
jkss-12-1f1.tif
Fig. 2.
Posteroanterior radiographs of a rabbit in the autograft group. At 12 weeks, homogeneous fusion masses were formed.
jkss-12-1f2.tif
Fig. 3.
Posteroanterior radiographs of a rabbit in the Cerabone A-W group. At 12 weeks, fusion masses seemed to be formed, but the porous structure of the graft was maintained. The proportion of the area occupied by Cerabone A-W in final radiograph over the area occupied by ceramics in the initial radiograph was almost the same. (A) Immediate postoperative, (B) postoperative 12 weeks.
jkss-12-1f3.tif
Fig. 4.
Posteroanterior radiographs of a rabbit in the CSPB2 group. (A) Immediate postoperative, (B) postoperative 12 weeks.
jkss-12-1f4.tif
Fig. 5.
Posteroanterior radiographs of a rabbit in the CSPB3 group. (A) Immediate postoperative, (B) postoperative 12 weeks.
jkss-12-1f5.tif
Fig. 6.
Histologic results of Cerabone A-W 12 weeks after surgery. The bone is directly attached to pores, the contours of which are nearly intact (Undecalcified, H&E staining, × 40). White circles indicate the Cerabone A-W implant, black arrows indicate newly formed bone.
jkss-12-1f6.tif
Fig. 7.
Histologic results of CSPB2 12 weeks after surgery. The bone is directly attached to pores, the contours of which are nearly intact (Undecalcified, H&E staining,× 40). White circles indicates the CSPB2 implant, black arrows indicate newly formed bone.
jkss-12-1f7.tif
Fig. 8.
Histologic results of CSPB3 12 weeks after surgery. The bone is directly attached to pores, the contours of which are nearly intact (Undecalcified, H&E staining,× 40). White circles indicates the CSPB3 implant, black arrows indicate newly formed bone.
jkss-12-1f8.tif
Table 1.
Summary of fusion rate, radiomorphometric of lumbar intertransverse process fusions, and ultimate tensile strength.
Fusion rate (%) Proportion of area occupied by ceramics in final X-ray (%) mean tensile strength (N)
Cerabone-AW 80   90.8± 14.0 a 214.± 57.3
CSPB2 81.8 73.1± 11.5 aa 217± 66.1
CSPB3 90.9 73.5± 10.0 aa 217± 70.1

a & aa Indicate statistically different data by Kruskall-Wallis test, p<0.05

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