The effect of anterior interbody cage boron application in rabbit vertebrae on bone fusion and fusion quality

Abstract

OBJECTIVE: Our aim in this study was to demonstrate the effectiveness of hydroxyapatite (HA) and Boron compounds in operations using an Anterior Lumbar Interbody Fusion (ALIF). MATERIAL AND METHODS: In the study, 18 male rabbits of New Zealand breed weighing 2.5-3 kg were used. The animals who were hospitalized on the left side underwent flank incision after surgical cleaning. Lumbar 5-6 distance was reached from the lumbar retroperitoneal region. Following anterior discectomy; ALIF was performed using PEEK (polyethylene ether ketone) cage (Group I) in the control group, PEEK cage and 50 mg/kg boron (borax pentahydrate) (Group II) in the boron group, PEEK cage and 50 mg/kg powder ProOsteon (Group III) in the HA group. The ALIF operation has been applied to all groups. Six weeks later, the animals underwent a computed tomography (CT) scan. Then the lower and upper vertebrae of the sacrificed animals at the distance at which discectomy was performed and the cage was placed were removed, separated for pathology. After being microscopically detected with buffered 10% formaldehyde overnight, the sections prepared from the sample tissues that were routinely followed were stained with hematoxin-eosin and examined histopathologically with light microscopy. RESULTS: While the osteoclast score was 1 in 83.3% of the boron group, it was 2 in 16.6%. In the same group, the osteoblast score was found to be 1 in 50% and 2 in 50%. The osteoclast score of the HA group was 1 in 50%, 2 in 50%, while the osteoblast score was found in 50%, 1 in 2, 2 in 16.6%, and 3 in 33.4%. Higher osteoblast and osteoclast scores were observed in HA group compared to Boron and control groups. It was observed that the boron group had higher osteoblast and osteoclast scores than the control group and lower than the HA group. CONCLUSIONS: Boron and Hydroxyapatite have been shown to form stones of the same size. Although morphologically not as much as boron, hydroxyapatite, histopathological examination showed that it formed a better amount of fusion compared to the control group. The osteoblastic activity was most common in the hydroxyapatite group.