Total intervertebral disc replacement using bioactive three-dimensional fabrics. a biomechanical and histologic study

摘要

We have developed a new artificial intervertebral disc prosthesis consisting of a triaxial three-dimensional fabric (3-DF) woven by an ultra-high molecular weight polyethylene fiber and spray-coated bioactive ceramics on the disc surface. The arrangement of weave properties led to the mechanical behavior of 3-DF disc similar to the natural intervertebral disc. Using a sheep model, total intervertebral replacement using 3-DF disc either coated by hydroxyapatite or apatite-wollastonite glass ceramics was conducted with or without initial fixation. Without the use of initial fixation, interface bony union was detected, however, the segmental motion decreased at six months postoperatively. The use of temporary fixation provided a nearly physiological mobility as well as the increased fusion rate at six months. A scanning electron microscopy showed that each fiber of 3-DF disc had a direct contact to trabecula. This study first highlighted the in vivo effectiveness of artificial intervertebral disc experimentally, and clarified further problems in clinical application.