Abstract
The implant used in spinal fusion procedures is an essential component to achieving successful arthrodesis. At the cellular level, the implant impacts healing and fusion through a series of steps: first, mesenchymal stem cells (MSCs) need to adhere and proliferate to cover the implant; second, the MSCs must differentiate into osteoblasts; third, the osteoid matrix produced by the osteoblasts needs to generate new bone tissue, thoroughly integrating the implant with the vertebrate above and below. Previous research has demonstrated that microtextured titanium is advantageous over smooth titanium and PEEK implants for both promoting osteogenic differentiation and integrating with host bone tissue; however, no investigation to date has examined the early morphology and migration of MSCs on these surfaces. This study details cell spreading and morphology changes over 24 h, rate and directionality of migration 6–18 h post-seeding, differentiation markers at 10 days, and the long-term morphology of MSCs at 7 days, on microtextured, acid-etched titanium (endoskeleton), smooth titanium, and smooth PEEK surfaces. The results demonstrate that in all metrics, the two titanium surfaces outperformed the PEEK surface. Furthermore, the rough acid-etched titanium surface presented the most favorable overall results, demonstrating the random migration needed to efficiently cover a surface in addition to morphologies consistent with osteoblasts and preosteoblasts.
Highlights
Spinal fusion surgery combines two or more vertebrae together to reduce discomfort by immobilizing a painful vertebral motion segment and restoring spinal stability (Williams et al, 2005; Nouh, 2012; Obrigkeit et al, 2012)
The goals of the present study were to examine the early responses of mesenchymal stem cells (MSCs) to each of the surfaces, and identify if the early response was predictive of the known long-term osteoblastic differentiation and establishment of MSC migration and morphology
Random cell migration is significant in generating the uniform population distribution that will lead to uniform coverage of the surface by the MSCs (Gail and Boone, 1970)
Summary
Spinal fusion surgery combines (or fuses) two or more vertebrae together to reduce discomfort by immobilizing a painful vertebral motion segment and restoring spinal stability (Williams et al, 2005; Nouh, 2012; Obrigkeit et al, 2012). Following surgery, it can take 6–12 months for the fusion process to occur (Obrigkeit et al, 2012).
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