Evaluation of Bioabsorbable Multiamino Acid Copolymer/Nanohydroxyapatite/Calcium Sulfate Cage in a Goat Spine Model.

Abstract

Currently, polylactide is the most popular material used to made bioabsorbable cages but too-quick degradation and osteolysis around the cage have been reported in the literature. This study evaluated the fusion effect, biomechanical stability, and histologic characteristics of a novel bioabsorbable multiamino acid copolymer/nanohydroxyapatite/calcium sulfate (MAACP/n-HA/CS) interbody cage in a goat model of anterior cervical discectomy and fusion. A total of 24 goats underwent C3/C4 discectomy and fusion with 3 groups of intervertebral implants: MAACP/n-HA/CS cage group (n= 8), titanium cage group (n= 8), and autologous tricortical iliac crest bone group (n= 8). Disc space height and lordosis angle were measured pre- and postoperatively and after 4, 12, and 24 weeks. Range of motion (ROM) was evaluated through biomechanical testing. Histologic analysis was performed to evaluate fusion status and to detect any foreign body reactions associated with the bioabsorbable cages. At 12 and 24 weeks, disc space height in MAACP/n-HA/CS cage group was greater than that of titanium cage group and tricortical iliac crest group (P < 0.05). Lordosis angle in MAACP/n-HA/CS cage group and titanium cage group were lower than that of tricortical iliac crest group (P < 0.05). Biomechanical test showed that ROM did not differ significantly between MAACP/n-HA/CS cage group and titanium cage group, whereas the value of ROM in bone graft group was the largest. Histologic evaluation showed a better interbody fusion in the MAACP/n-HA/CS cage group than in the other 2 groups. MAACP/n-HA/CS cage surface degraded and was absorbed at 24 weeks. All MAACP/n-HA/CS cages showed excellent biocompatibility. MAACP/n-HA/CS cages can provide good fusion effect, enough biomechanical stability, and integrate closely with the surrounding bone.