Outstanding in vivo mechanical integrity of additively manufactured spinal cages with a novel “honeycomb tree structure” design via guiding bone matrix orientation

Ishimoto, Takuya; Kobayashi, Yoshiya; Takahata, Masahiko; Ito, Manabu; Matsugaki, Aira; Takahashi, Hiroyuki; Watanabe, Ryota; Inoue, Takayuki; Matsuzaka, Tadaaki; Ozasa, Ryosuke; Hanawa, Takao; Yokota, Katsuhiko; Nakashima, Yoshio; Nakano, Takayoshi

doi:https://doi.org/10.1016/j.spinee.2022.05.006

Outstanding in vivo mechanical integrity of additively manufactured spinal cages with a novel “honeycomb tree structure” design via guiding bone matrix orientation

Ishimoto, Takuya; Kobayashi, Yoshiya; Takahata, Masahiko et al.

Spine Journal, 2022, 22(10), 1742-1757

Number of Access:1,529（2025-07-18 09:51 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/89746

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Title	Outstanding in vivo mechanical integrity of additively manufactured spinal cages with a novel “honeycomb tree structure” design via guiding bone matrix orientation
Creator	NRID 1000050508835 1000050508835 ORCID 0000-0003-0081-0591 0000-0003-0081-0591 researchmap permalink i_taku i_taku Scopus Author ID 35310484700 35310484700 CreatorName Ishimoto, Takuya
	CreatorName Kobayashi, Yoshiya
	NRID 1000040374368 1000040374368 CreatorName Takahata, Masahiko
	NRID 1000000271677 1000000271677 CreatorName Ito, Manabu
	NRID 1000010592529 1000010592529 ORCID 0000-0002-8427-7124 0000-0002-8427-7124 researchmap permalink aira aira Scopus Author ID 24172720900 24172720900 CreatorName Matsugaki, Aira
	CreatorName Takahashi, Hiroyuki
	CreatorName Watanabe, Ryota
	CreatorName Inoue, Takayuki
	CreatorName Matsuzaka, Tadaaki
	NRID 1000080845347 1000080845347 ORCID 0000-0002-2773-072X 0000-0002-2773-072X researchmap permalink ozasa_r ozasa_r Scopus Author ID 56202812400 56202812400 CreatorName Ozasa, Ryosuke
	NRID 1000090142736 1000090142736 CreatorName Hanawa, Takao
	CreatorName Yokota, Katsuhiko
	CreatorName Nakashima, Yoshio
	NRID 1000030243182 1000030243182 ORCID 0000-0001-8052-1698 0000-0001-8052-1698 researchmap permalink read0013987 read0013987 Scopus Author ID 7403896013 7403896013 CreatorName Nakano, Takayoshi
Subject	Anisotropy
	Bone matrix
	Bone quality
	Collagen/apatite orientation
	Pull-out strength
	Spinal cage
	Trabecular architecture
Description	Ishimoto T., Kobayashi Y., Takahata M., et al. Outstanding in vivo mechanical integrity of additively manufactured spinal cages with a novel “honeycomb tree structure” design via guiding bone matrix orientation. Spine Journal, 22, 10, 1742. https://doi.org/10.1016/j.spinee.2022.05.006.
Abstract	BACKGROUND CONTEXT: Therapeutic devices for spinal disorders, such as spinal fusion cages, must be able to facilitate the maintenance and rapid recovery of spinal function. Therefore, it would be advantageous that future spinal fusion cages facilitate rapid recovery of spinal function without secondary surgery to harvest autologous bone. PURPOSE: This study investigated a novel spinal cage configuration that achieves in vivo mechanical integrity as a devise/bone complex by inducing bone that mimicked the sound trabecular bone, hierarchically and anisotropically structured trabeculae strengthened with a preferentially oriented extracellular matrix. STUDY DESIGN/SETTINGS: In vivo animal study. METHODS: A cage possessing an anisotropic through-pore with a grooved substrate, that we termed “honeycomb tree structure,” was designed for guiding bone matrix orientation; it was manufactured using a laser beam powder bed fusion method through an additive manufacturing processes. The newly designed cages were implanted into sheep vertebral bodies for 8 and 16 weeks. An autologous bone was not installed in the newly designed cage. A pull-out test was performed to evaluate the mechanical integrity of the cage/bone interface. Additionally, the preferential orientation of bone matrix consisting of collagen and apatite was determined. RESULTS: The cage/host bone interface strength assessed by the maximum pull-out load for the novel cage without an autologous bone graft (3360±411 N) was significantly higher than that for the conventional cage using autologous bone (903±188 N) after only 8 weeks post-implantation. CONCLUSIONS: These results highlight the potential of this novel cage to achieve functional fusion between the cage and host bone. Our study provides insight into the design of highly functional spinal devices based on the anisotropic nature of bone. CLINICAL SIGNIFICANCE: The sheep spine is similar to the human spine in its stress condition and trabecular bone architecture and is widely recognized as a useful model for the human spine. The present design may be useful as a new spinal device for humans.
Publisher	Elsevier
Source Title	Spine Journal
Volume (Issue)	22(10)
Page	1742-1757
Date of Issued	2022-10-01
Language	English
Handle URL	https://hdl.handle.net/11094/89746
PISSN	15299430
eISSN	18781632
NCID	AA11563339
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1016/j.spinee.2022.05.006
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Spine Journal. 2022, 22(10), p. 1742-1757
DC.title	Outstanding in vivo mechanical integrity of additively manufactured spinal cages with a novel “honeycomb tree structure” design via guiding bone matrix orientation
DC.creator	Ishimoto, Takuya
	Kobayashi, Yoshiya
	Takahata, Masahiko
	Ito, Manabu
	Matsugaki, Aira
	Takahashi, Hiroyuki
	Watanabe, Ryota
	Inoue, Takayuki
	Matsuzaka, Tadaaki
	Ozasa, Ryosuke
	Hanawa, Takao
	Yokota, Katsuhiko
	Nakashima, Yoshio
	Nakano, Takayoshi
DC.publisher	Elsevier
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2022-10-01
DC.identifier	https://doi.org/10.1016/j.spinee.2022.05.006
DC.subject	Anisotropy
	Bone matrix
	Bone quality
	Collagen/apatite orientation
	Pull-out strength
	Spinal cage
	Trabecular architecture
DC.description	Ishimoto T., Kobayashi Y., Takahata M., et al. Outstanding in vivo mechanical integrity of additively manufactured spinal cages with a novel “honeycomb tree structure” design via guiding bone matrix orientation. Spine Journal, 22, 10, 1742. https://doi.org/10.1016/j.spinee.2022.05.006.
DCTERMS.abstract	BACKGROUND CONTEXT: Therapeutic devices for spinal disorders, such as spinal fusion cages, must be able to facilitate the maintenance and rapid recovery of spinal function. Therefore, it would be advantageous that future spinal fusion cages facilitate rapid recovery of spinal function without secondary surgery to harvest autologous bone. PURPOSE: This study investigated a novel spinal cage configuration that achieves in vivo mechanical integrity as a devise/bone complex by inducing bone that mimicked the sound trabecular bone, hierarchically and anisotropically structured trabeculae strengthened with a preferentially oriented extracellular matrix. STUDY DESIGN/SETTINGS: In vivo animal study. METHODS: A cage possessing an anisotropic through-pore with a grooved substrate, that we termed “honeycomb tree structure,” was designed for guiding bone matrix orientation; it was manufactured using a laser beam powder bed fusion method through an additive manufacturing processes. The newly designed cages were implanted into sheep vertebral bodies for 8 and 16 weeks. An autologous bone was not installed in the newly designed cage. A pull-out test was performed to evaluate the mechanical integrity of the cage/bone interface. Additionally, the preferential orientation of bone matrix consisting of collagen and apatite was determined. RESULTS: The cage/host bone interface strength assessed by the maximum pull-out load for the novel cage without an autologous bone graft (3360±411 N) was significantly higher than that for the conventional cage using autologous bone (903±188 N) after only 8 weeks post-implantation. CONCLUSIONS: These results highlight the potential of this novel cage to achieve functional fusion between the cage and host bone. Our study provides insight into the design of highly functional spinal devices based on the anisotropic nature of bone. CLINICAL SIGNIFICANCE: The sheep spine is similar to the human spine in its stress condition and trabecular bone architecture and is widely recognized as a useful model for the human spine. The present design may be useful as a new spinal device for humans.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	89746
citation_title	Outstanding in vivo mechanical integrity of additively manufactured spinal cages with a novel “honeycomb tree structure” design via guiding bone matrix orientation
citation_author	Ishimoto, Takuya
	Kobayashi, Yoshiya
	Takahata, Masahiko
	Ito, Manabu
	Matsugaki, Aira
	Takahashi, Hiroyuki
	Watanabe, Ryota
	Inoue, Takayuki
	Matsuzaka, Tadaaki
	Ozasa, Ryosuke
	Hanawa, Takao
	Yokota, Katsuhiko
	Nakashima, Yoshio
	Nakano, Takayoshi
citation_publisher	Elsevier
citation_language	English
citation_date	2022-10-01
citation_journal_title	Spine Journal
citation_volume	22
citation_issue	10
citation_firstpage	1742
citation_lastpage	1757
citation_doi	https://doi.org/10.1016/j.spinee.2022.05.006
citation_public_url	https://hdl.handle.net/11094/89746

Outstanding in vivo mechanical integrity of additively manufactured spinal cages with a novel “honeycomb tree structure” design via guiding bone matrix orientation

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