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Biocompatibility of fixation materials in the brain
M M Mofid1, R C Thompson, C A Pardo
1Department of Plastic, Reconstructive, and Maxillofacial Surgery, Johns Hopkins University School of Medicine, Baltimore 21287-0981, Md, USA.
Plastic and Reconstructive Surgery
|July 1, 1997
Summary
Concerns about craniofacial surgery implants prompted a study on brain biocompatibility. Titanium and Vitallium showed similar, moderate brain inflammation, while stainless steel caused more, unlike silicone controls.
Area of Science:
- Neuroscience
- Biomaterials Science
- Surgical Innovation
Background:
- Clinical reports indicate passive intracranial translocation of microplates and microscrews.
- Concerns exist regarding brain biocompatibility and neurotoxicity of craniofacial fixation hardware.
- Limited comprehensive studies exist on the brain biocompatibility of common surgical implant materials.
Purpose of the Study:
- To evaluate the biocompatibility of titanium, Vitallium, and 316L stainless steel in the rabbit brain.
- To compare the brain tissue response to these metals with silicone elastomer, a known neurosurgical implant material.
- To assess potential neurotoxicity and inflammatory responses to common craniofacial fixation materials.
Main Methods:
- Forty-eight rabbits were implanted with titanium microscrews, Vitallium microscrews, or 316L stainless steel wire in one hemisphere.
- Silicone elastomer strips were implanted contralaterally as a control.
- Animals were monitored for neurotoxicity, and brains were analyzed histologically and immunohistochemically at 2, 4, 8, and 26 weeks.
Main Results:
- No animals exhibited behavioral changes or neurological deficits indicative of toxicity.
- Silicone elastomer elicited the least inflammation, confirming its suitability as a control.
- Titanium initially caused a significant inflammatory response, but its biocompatibility approached Vitallium by 26 weeks.
- Stainless steel showed a progressive increase in inflammation, with the highest leukocyte response at 26 weeks.
Conclusions:
- Titanium and Vitallium demonstrate comparable, moderate brain tissue inflammatory responses at 26 weeks.
- Stainless steel elicits a greater inflammatory response compared to titanium and Vitallium in brain tissue.
- Silicone elastomer remains a suitable control material for brain biocompatibility studies, showing minimal inflammation.