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Bioabsorbable cages in spinal fusion in an animal model: a systematic review and meta-analysis

Sylvio Mistro, M. Risso, Rafael Magalhães Grana, M. Lima, André Frazão Rosa, Alberto Cliquet

Acta Ortopédica Brasileira, 2025

Abstract

ABSTRACT To evaluate the efficacy of bioabsorbable interbody cages in comparison with conventional techniques in animal models, with emphasis on the impact of follow-up time on developments. A systematic review and meta-analysis was performed including 11 studies on the use of bioabsorbable cages in comparison with conventional techniques. The odds ratio (OR) was calculated for range of motion (ROM), and heterogeneity was assessed by Cochran's Q test. Descriptive statistical analyses and hypothesis tests were performed to evaluate the parameters of fusion rate, intervertebral disc height and ROM. The 11 studies included totaled 244 animals. The analysis revealed a cumulative OR of 1.70 for ROM and fusion rate in the first four months of follow-up. No significant differences were found in height parameters in the study follow-ups. Heterogeneity among studies was low, indicating consistency in the results. The analysis suggests that bioabsorbable cages have advantages in periods of less than four months, and that there is no inferiority in the results in follow-up periods longer than four months in terms of fusion rate, ROM and intervertebral height in long-term experimental studies, and further research is needed to determine their clinical applicability. Level of Evidence ll; Systematic meta-analytical review of non-randomized controlled clinical studies whose results were homogeneous .

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Evidence Hub reads this as a meta-analysis, done in animal, not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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