Tantalum powder- Clinical effects of tantalum metal

Clinical effects of tantalum metal:

Tantalum metal has been widely used in several fields, and the use of tantalum metal in spine surgery is also increasing. First, the appearance of porous tantalum is similar to cancellous bone, its elastic modulus (about 3 GPa) is similar to cancellous bone (3.78 GPa) and cortical bone (14.64 GPa), and it has strong bending resistance. The porosity of porous tantalum is as high as 75% to 80%, which is much higher than other commonly used metals. Tantalum implants have a relatively low infection rate, and the reinfection rate for spinal infections treated with tantalum metal cages is 0%.

Application of porous tantalum in lumbar spine fusion

This section analyzes the clinical effects of two different types of surgical approaches combined with porous tantalum cages. Among them, Cuzzocrea et al. and Jalalpour et al. used transforaminal lumbar interbody fusion (TLIF), while van de Kelft et al. and Lequin et al. used posterior lumbar interbody fusion (PLIF).

Researchers Cuzzocrea et al. randomly selected 40 patients to receive metal cages (porous tantalum metal or titanium metal) or PEEK cages for TLIF treatment. They found that pain and function scores improved and were similar in both groups at 1-year follow-up. But the fusion rate was higher in the metal implant group (90 percent) than in the PEEK group (69 percent).

Jalalpour et al. applied porous tantalum cages in TLIF and posterolateral fusion (PLF). The study included patients with low back pain for more than 1 year. After 2 years of follow-up, both groups had statistically significant improvements in visual analogue scale (VAS) and disability rating index (DRI). However, Porous tantalum cages provide better clinical results. The revision rate of the TLIF group using porous tantalum cages (7.4%) was lower than that of the PLF group (17.9%), and the fusion rate of both groups was as high as 90%.

van de Kelft et al. and Lequin et al. applied porous tantalum fusion devices to PLIF. A study by van de Kelft et al compared the effect of porous tantalum cages alone or with pedicle screw fixation. Results at 24 months of follow-up showed no difference in pain and function scores. However, using a porous tantalum fusion cage alone shortens the operation time and significantly reduces blood loss. The incidence of meningeal tears in the pedicle screw fixation group (10%) was higher than that in the porous tantalum cage alone group (5%). The revision rate due to screw loosening and other reasons (2.5%) was higher than that of the cage alone group (0%), but the incidence of adjacent segment degeneration was lower (2.6%). Lequin found that in the patient group of 26 patients (62% male), after PLE treatment with porous tantalum cages, 12 patients (46%) had a good overall feeling recovery after 15 months of follow-up. In terms of treatment satisfaction, 1 patient (69%) was satisfied or very satisfied with the surgery and would recommend surgery.