Evaluation of the biological response of wear debris

Study design: An animal study was conducted to evaluate the biological response to titanium particles from an artificial intervertebral disc in terms of serology and histologic changes. Objectives: To determine the biological response to wear debris in the retroperitoneal and epidural space. Summary of background data: Few wear studies exist about mechanical artificial discs. Methods: Twenty-three New Zealand white rabbits were used for two approaches of the lumbar spine. In a retroperitoneal group (10 rabbits), lateral flank approach at the L2-L3 area was used. In an epidural group (13 rabbits), a dorsal laminotomy of L2 was performed. The wear debris was obtained from mechanical test cycling of the implantable intervertebral disc. At 4 and 12 weeks postoperatively, five or six animals from each group were killed. The tissues, including deposition site, regional lymph nodes and major organs, were evaluated with hematoxylin and eosin staining. Results: At death all rabbits were found to be healthy. Blood results from the predeath samples were found to be consistent with the preoperative blood work values. Scar tissue was minimal with good healing. All organs were found to be normal in appearance. On histopathology sections, adverse reactions such as fibrosis, granuloma formation or necrosis were not found in any tissues. Free particles were found sparingly in all tissue sections with minimal cellular response. No remarkable difference was found according to groups or time intervals. Smaller particles were found to be engulfed in macrophages without adverse biological consequences. Conclusion: Titanium particles traveled from the sites of deposition but elicited no to minimal biological response.