Study Design. Antimicrobial effect of a novel silver-impregnated pedicle screw in rabbits. Objective. A novel spine implant model was designed to study the antimicrobial effect of a modified Titanium (Ti) pedicle screws with methicillin-resistant Staphylococcus aureus (MRSA) in multiple surgical sites in the lumbar spine of a rabbit. Summary of Background Data. Infection in spinal implant is of great concern. Anti-infection strategies must be tested in relevant animal models that will lead to appropriate clinical studies. Methods. Fourteen New Zealand white rabbits were divided into 2 groups: group 1: infected unmodified Ti screw group (n = 6), and group 2: infected polyethylene glycol grafted, polypropylene-based silver nanoparticle (PP-g-PEG-Ag) covered Ti screw group (n = 6), and 2 rabbits as sterile (sham-operated and control) group. In all groups, left L4–right L6 vertebra levels were exposed and screws were drilled to transverse processes after contamination of burr holes and surrounding tissue with 0.1 mL of 10⁶ colony forming units (CFU) MRSA solutions in groups 1 and 2. After 21 days, samples were collected and infection was analyzed via light and scanning electron microscopy and culturing. Silver nanoparticles (Ag-NP) on the screws and tissues were assayed pre and postoperatively. Results. The bacterial colony count for modified-Ti screw group was lower than for unmodified Ti screw (17.2 versus 200 x 10³ CFU/mL, P = 0.029) with less biofilm formation. There was no difference in duration of surgery among groups and within the surgical sites. Ag-NPs were detected on the screw surface postoperatively. Conclusion. This novel experimental design of implantation in rabbits is easy to apply and resembles human stabilization technique. Modified Ti screws were shown to have antimicrobial effect especially inhibiting the biofilm formation. This anchored Ag NPs that remained after 21st day of implantation shows that it is resistant to tapping forces of the screw. Level of Evidence: N/A

Aim. We discuss technical points, the safety, and efficacy of ultrasonic bone shaver in various spinal surgeries within our own series.Methods. Between June 2010 and January 2014, 307 patients with various spinal diseases were operated on with the use of an ultrasonic bone curette with microhook shaver (UBShaver). Patients’ data were recorded and analyzed retrospectively. The technique for the use of the device is described for each spine surgery procedure.Results. Among the 307 patients, 33 (10.7%) cases had cervical disorder, 17 (5.5%) thoracic disorder, 3 (0.9%) foramen magnum disorder, and 254 (82.7%) lumbar disorders. Various surgical techniques were performed either assisted or alone by UBShaver. The duration of the operations and the need for blood replacement were relatively low. The one-year follow-up with Neck Disability Index (NDI) and Oswestry Disability Index (ODI) scores were improved. We had 5 cases of dural tears (1.6%) in patients with lumbar spinal disease. No neurological deficit was found in any patients.Conclusion. We recommend this device as an assistant tool in various spine surgeries and as a primary tool in foraminotomies. It is a safe device in spine surgery with very low complication rate.

Biocompatibility studies of the autoxidized and unoxidized unsaturated medium-long chain length (m-lcl) co-poly-3-hydroxyalkanoates (m-lclPHAs) derived from soya oily acids have been reported. Pseudomonas oleovorans was grown on a series of mixtures of octanoic acid (OA) and soya oily acids (Sy) with weight ratios of 20:80, 28:72 and 50:50 in order to obtain unsaturated m-lcl copolyesters coded PHO-Sy-2080, PHO-Sy-2872 and PHO-Sy-5050, respectively. The PHA films were obtained by solvent cast from CHCl(3). They were all originally sticky and waxy except PHO-Sy-5050. Autoxidation of the unsaturated copolyester films was carried out on exposure to air at room temperature in order to obtain crosslinked polymers. They became a highly flexible elastomer after being autoxidized (about 40 days of autoxidation). The in vivo tissue reactions of the autoxidized PHAs were evaluated by subcutaneous implantation in rats. The rats appeared to be healthy throughout the implantation period. No symptom such as necrosis, abscess or tumorigenesis was observed in the vicinity of the implants. Retrieved materials varied in their physical appearance after 6 weeks of implantation. In vivo biocompatibility studies of the medical applications indicated that the microbial copolyesters obtained were all biocompatible and especially the PHOSy series of copolyesters had the highest biocompatibility among them.

Hazer DB, et al. Korean J Pain. 2018 Apr;31(2):109-115. https://doi.org/10.3344/kjp.2018.31.2.109

This study aims to investigate the degree of biocompatibility and neuroregeneration of a polymer tube, poly-3-hydroxyoctanoate (PHO) in nerve gap repair. Forty Wistar Albino male rats were randomized into two groups: autologous nerve gap repair group and PHO tube repair group. In each group, a 10-mm right sciatic nerve defect was created and reconstructed accordingly. Neuroregeneration was studied by sciatic function index (SFI), electromyography, and immunohistochemical studies on Days 7, 21, 45 and 60 of implantation. Biocompatibility was analyzed by the capsule formation around the conduit. Biodegradation was analyzed by the molecular weight loss in vivo. Electrophysiological and histomorphometric assessments demonstrated neuroregeneration in both groups over time. In the experimental group, a straight alignment of the Schwann cells parallel to the axons was detected. However, autologous nerve graft seems to have a superior neuroregeneration compared to PHO grafts. Minor biodegradation was observed in PHO conduit at the end of 60 d. Although neuroregeneration is detected in PHO grafts with minor degradation in 60 d, autologous nerve graft is found to be superior in axonal regeneration compared to PHO nerve tube grafts. PHO conduits were found to create minor inflammatory reaction in vivo, resulting in good soft tissue response.