The Evolution of Interbody Fusion

Advancing patient care with our newest 3D printed tantalum interbody platform. Engineered for the perfect balance of porosity and strength, the distinctive structure of these spinal cages are designed for an optimal scaffold. Available in a broad range of sizes, the Avenue® Tx Interbody System is designed to fit the anatomy of all patients.  

The comprehensive Avenue® Interbody product range consists of both static 3D printed Tantalum, and static, built-in fixation and expandable 3D printed Titanium. 

The Avenue Ta line of products is designed to have the following structural, functional, and physiological features:

Wide Variety of Footprints, Heights and Lordosis Angles

One system intended to match patients’ natural anatomy and surgeons’ preferences.

Primary Stability

The special “net” structure obtained through additive manufacturing technology, is designed to provide strong primary fixation and to minimize implant migration risk.

Fusion Promotion

Pore size of the net structure and the surface roughness of the implant edges intended to facilitate fast and effective osteo-integration.

The elasticity modulus of the implant, similar to PEEK, is designed to be close to natural bone characteristics.

Tantalum is one of the most Chemically Stable Metals

Porous Trabecular Metal in Tantalum has been used in Orthopaedic implants for more than 25 years with plenty of clinical publications evaluating its use.1-13

Microporosity and surface roughness designed to increase friction and limit micromotion for excellent stability

   
   
   

Tantalum in Medical Applications1

Numerous articles have been published that reviewed the use of tantalum for orthopedic applications2.

These articles review the reported attributes in these applications, such as Tantalum’s inert bioactivity3, antithrombotic property; enhancement of macrophage response4 and bactericidal properties5.

Specific studies have noted the porous Tantalum morphology as a framework for bone growth and osteoblast interaction6

According to one of the publications reviewed, additional evidence have indicated that human osteoblasts (cell line hFOB) exhibit potentially six time higher living cell density on Tantalum as compared to Titanium7.

Selective Laser Melting (SLM) produced tantalum porous-structure also seemed to demonstrate mechanical properties relatively similar to human bone and  osseointegration as compared to similar porous Ti-6Al-4V structures.

A conclusion reached from one of these works was that “laser-melted tantalum shows excellent osteoconductive properties, has higher normalized fatigue strength and allows for more plastic deformation due to its high ductility”8.

   

Bacterial Adherence to Tantalum Versus Commonly Used Orthopedic Metallic Implant Materials9

Based on the results of this study9, pure tantalum presents with a lower or similar S. aureus and S. epidermidis adhesion when compared with other commonly used materials.

Because bacterial adhesion is an important predisposing factor in the development of clinical implant infection, Tantalum may offer benefits as an adjunct or alternative material compared with current materials commonly used for orthopedic implants.

Figure 19. Adhesion of S. aureus to metallic implants. The data (mean values ± SD of  independent experiments, n = 5) represent the percentage of metallic surface area covered by bacteria as analyzed by fluorescence  microscopy and digital image processing.

Figure 29. Adhesion of S. epidermidis to metallic implants. The data (mean values ± SD of  independent experiments, n = 5) represent the percentage of metallic surface area covered  by bacteria as analyzed by fluorescence  microscopy and digital image processing.

Tantalum Imaging Basics

Based on collected data, on Magnetic Resonance Imaging, the porous tantalum implant demonstrated less artifact than did the titanium spacer on T1- and T2-weighted spin  echo and on T2*-weighted gradient-echo magnetic resonance images. On Computed Tomographic scans, more streak artifact was associated with the tantalum implants  than with the titanium12, 13

Imaging devices manufacturers typically offer different tools and recommendations to minimize artifacts generated by metal implants on both MRI and CT. Check corresponding device manuals for further information.

Figure 413.  1 year following ACDF, new onset symptoms prompted a Magnetic Resonance Imaging (MRI) study. a) Axial T1 images. b) sagittal T2 images both show excellent resolution of neural structures.

Figure 513.  71 year male with multiple myeloma at L5 who presented with cauda equina syndrome; treated with anterior-posterior fusion using a Trabecular Metal implant. a) Sagittal computed tomography (CT) image after decompression with posterior stabilization. L5 shows extensive involvement. b) X-ray 6 weeks post op. c) Sagittal CT of the TM implant. d) Coronal CT of the TM implant. e) Axial CT of the TM implant.

Magnetic Resonance Imaging

Less Artifacts than Ti on MRI

Avenue® Ti Family
   
   

Important Information

Additional Information

To request a paper copy of the Instructions for Use, contact ZimVie Spine Customer Service