Bioabsorbable high-purity magnesium interbody cage: degradation, interbody fusion, and biocompatibility from a goat cervical spine model

Abstract

Background: Bioabsorbable Mg-based implants have been a focus of orthopedic researches due to their intrinsic advantages in orthopedics surgeries. This study aimed to investigate the performance of bioabsorbable high-purity magnesium (HP Mg, 99.98 wt.%) interbody cages in anterior cervical discectomy and fusion (ACDF) and to evaluate the degradation of HP Mg cages under an interbody microenvironment. Methods: ACDF was performed at C2-3 and C4-5, and a HP Mg cage or autologous iliac bone was randomly implanted. At 3, 6, 12 and 24 weeks after surgery, the cervical specimens were harvested to evaluate the fusion status, degradation and biocompatibility by CT, micro-CT, histological examinations and blood tests. Results: There was no significant difference in the CT fusion score between cage group and autogenous ilium group at 3 and 6 weeks. At 12 and 24 weeks, the mean CT fusion score in the cage group was markedly lower than in the autogenous ilium group. CT and histological examinations showed bony junctions formed through the middle hole of the cage between upper and lower vertebral bodies in the cage group, but the total fusion area was less than 30%. The degradation rate of cages was relatively rapid within the first 3 weeks and thereafter became stable and slow gradually. The HP Mg cage had good biosecurity and biomechanical characteristics. Conclusions: Implantation of Mg-based interbody cage achieves successful histological fusion, while the total fusion area needs to be improved. More studies are needed to improve the bone-cage interface.