2019 Volume 60 Issue 1 Pages 144-148
A spinal cage is one of the primary spinal devices used for the treatment of spinal diseases such as lumbar spondylolisthesis. Since it is set in the intervertebral space that causes instability to promote the fusion of the adjacent vertebral bodies, it requires the early induction of healthy bones. For this reason, in most cases, an autogenous bone extracted from the patient’s ilium is implanted in the interior of the cage to stimulate bone formation. However, collecting autogenous bone involves secondary surgery and several clinical problems such as pain in the part from which it is collected. Additionally, the effect of the autogenous bone graft itself has not been sufficiently studied yet. Moreover, the mechanical functions of trabecular bones in a vertebral body are governed by the anisotropic structure of the trabeculae and the preferential orientation of the apatite/collagen in a trabecula with respect to the principal stress. Despite this fact, after the implantation of the cage, the mass of the bones is evaluated with soft X-ray photography, which does not guarantee an accurate measurement of bone functions. In this study, the effect of the autogenous bone graft on the spinal cage was verified based on structural anisotropy of trabecular bones and the preferential orientation of apatite/collagen in a trabecula using sheep. The autogenous bone graft demonstrated a significant effect on the increase of bone mass and anisotropy of the trabecular structure. However, compared to the trabecular anisotropy of normal parts, the anisotropy of the trabecular structure and apatite c-axis orientation of the parts with autogenous bone graft were considerably lower, indicating a minimal effect of the autogenous bone graft. Therefore, it was suggested that early stabilization of the spinal cage requires another strategy that rapidly forms the unique hierarchical anisotropic structure of trabecular bones.