Page 301 - IJB-10-5

International

Journal of Bioprinting

RESEARCH ARTICLE
Double-protein-loaded 3D-printed

polyetheretherketone cage for promoting
interbody fusion via osteogenic differentiation

Feng Zheng 1,2† , Xiaoqiang Gao , Sheng Chai , Haibin Lin *, and Huan Liu *
2†
1†
1
3 id
1 Department of Orthopedics, Affiliated Hospital of Putian University, Putian, Fujian, China
2 The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China
3 Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital, Southwest
Medical University, Luzhou, Sichuan, China

Abstract
Intervertebral disc degeneration (IDD) is a common condition characterized by
age-related wear and tear of the spine. In advanced stages or severe cases of IDD,
surgical treatment involving the implantation of an interbody cage is often the
primary treatment approach. Polyetheretherketone (PEEK) has been widely used
in orthopedic and spinal implants due to its remarkable mechanical properties,
biocompatibility, and corrosion resistance. However, when used in interbody cages,
PEEK exhibits poor processability and biological inertness, which are significant
disadvantages that need to be addressed. In this work, we first fabricated the PEEK
cage via the fused deposition modeling (FDM) method. To improve its fusion effect,
† These authors contributed equally
to this work. bone morphogenetic protein 2 (BMP2) was loaded onto sulfonated PEEK and sealed
with gelatin/chitosan (Gel/Chi) multilayer films. Substance P was then grafted on
*Corresponding authors:
Haibin Lin (fsyy@ptu.edu.cn) the surface with a Schiff base. When the cage is implanted, substance P is released
Huan Liu (huanliu@swmu.edu.cn) first, recruiting bone marrow-mesenchymal stem cells (MSCs) to the implant surface.
Subsequently, upon degradation of the Gel/Chi multilayer films, BMP2 is slowly
Citation: Zheng F, Gao X, Chai S, released and promotes osteogenic differentiation of MSCs. In vivo results revealed

Lin H, Liu H. Double-protein-loaded

3D-printed polyetheretherketone that the double-protein-loaded PEEK cage exhibited remarkable fusion effects. This
cage for promoting interbody fusion work provides a novel approach for the design and fabrication of a PEEK intervertebral
via osteogenic differentiation. fusion device with an excellent fusion effect.
Int J Bioprint. 2024;10(5):3574.
doi: 10.36922/ijb.3574
Received: May 5, 2024 Keywords: Polyetheretherketone; 3D printing; Interbody cage;
Accepted: June 14, 2024 Mesenchymal stem cell recruitment
Published Online: July 29, 2024
Copyright: © 2024 Author(s).
This is an Open Access article
distributed under the terms of the
Creative Commons Attribution 1. Introduction
License, permitting distribution,
and reproduction in any medium, Intervertebral disc degeneration (IDD) is an age-related disease of the spine. Its clinical
provided the original work is manifestations involve the gradual breakdown or deterioration of structures in the
properly cited. lumbar spine. The early stages of IDD can be treated with conservative management,
1,2
3–5
Publisher’s Note: AccScience including physical therapy, physical interventions, and pain management. However,
Publishing remains neutral with in advanced stages or severe cases of IDD, surgical treatments, including discectomy,
regard to jurisdictional claims in 6,7
published maps and institutional laminectomy, and artificial disc replacement, are often preferred. Interbody cages,
affiliations. one of the most commonly used artificial disc devices, are placed between two adjacent

Volume 10 Issue 5 (2024) 293 doi: 10.36922/ijb.3574