J Korean Soc Spine Surg.  2005 Mar;12(1):1-11. 10.4184/jkss.2005.12.1.1.

Evaluation of Osteosynthesis in CaO-SiO2-P2O5-B2O3 Glass-ceramics by Posterolateral Fusion of Rabbit Lumbar vertebrae

• Lee JH
• Park KW
• Song KS
• Ryu HS
• Seo JH
• Hong KS
• Kim H
• Chang BS
• Lee CK

• KMID: 1897015
• DOI: http://doi.org/10.4184/jkss.2005.12.1.1

Abstract

STUDY DESIGN: A comparative in vivo study between ceramics with different compositions.
OBJECTIVES
To compare the biodegradation and osteoconduction properties of CaO-SiO2- P2O5- B2O3 glass-ceramics and Cerabone(R)-AW. Summary of Literature Review: Bioglass ceramics can be used as bone graft substitutes. However, no study has been undertaken to investigate the possibility of CaO-S i O2-P2O5-B2O3 glass-ceramics as a bone graft substitute. MATERIALS AND METHODS: Porous CSPB2 implants (44.07% CaO, 40.28% SiO2, 8.1% P2O5 and 5.0% B2O3), porous CSPB3 implants (43.76% CaO, 43.41% SiO2, 4.05% P2O5 and 7.5% B2O3) and porous Cerabone(R)-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(R)-AW. 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(R)-AW, CSPB2 and CSPB3 groups, respectively. The proportion of the area occupied by Cerabone(R)-AW (90.8 % +/- 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(R)-AW (214. +/- 57.3N), CSPB2 (214. +/- 57.3 N) and CSPB3 (217 +/- 70.1 N) 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(R)-AW; however, they degraded more rapidly than Cerabone(R)-AW. These findings suggest that CSPB2 and CSPB3 grafts can be used as a more ideal new bone graft substitutes than Cerabone(R)-AW.

Keyword

CaO-SiO2-P2O5-B2O3 glass-ceramics; A-W glass-ceramics; Biodegradation; Osteoconductivity; Bone graft substitute

MeSH Terms

Animals
Autografts
Bone Regeneration
Ceramics
Humans
Lumbar Vertebrae*
Male
Microscopy
New Zealand
Palpation
Polymers
Porifera
Rabbits
Spinal Fusion
Tensile Strength
Transplants
Ceramics
Polymers

Figure

• 

  Fig. 1. The calculation process using Image-ProⓇ Plus (Media Cybernetics, USA). Left: Immediate postoperative radiograph, Right: postoperative 12 weeks radiograph.

• 

  Fig. 2. Posteroanterior radiographs of a rabbit in the autograft group. At 12 weeks, homogeneous fusion masses were formed.

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  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.

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  Fig. 4. Posteroanterior radiographs of a rabbit in the CSPB2 group. (A) Immediate postoperative, (B) postoperative 12 weeks.

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  Fig. 5. Posteroanterior radiographs of a rabbit in the CSPB3 group. (A) Immediate postoperative, (B) postoperative 12 weeks.

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  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.

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  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.

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  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.

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