Design and development of the additively manufactured Zn-Li scaffolds for posterolateral lumbar fusion

Spinal fusion is a commonly used technique to treat acute and chronic spinal diseases by fusion of the adjacent vertebrae, aiming at achieving stability and eliminating the mobility of the objective segment. While bone autografts and allografts have been conventionally used for spinal fusion, limitations persist in achieving optimization of both good osteoinductive capacity and mechanical stability. In this study, additively manufactured Zn-Li scaffolds were developed and evaluated for their potential in spinal fusion. First, three scaffold structures (BCC, Diamond, and Gyroid) were designed and verified in vitro. Due to the smooth transition surfaces and uniform degradation behavior, the Gyroid Zn-Li scaffold demonstrated mechanical integrity during degradation and enhanced cellular proliferation compared to the other two scaffolds. Subsequently, Zn-Li scaffolds (Gyroid) were selected for posterolateral lumbar fusion (L4/L5) in rabbits. Following 12 weeks of implantation, the Zn-Li scaffolds demonstrated a moderate biodegradation rate and satisfactory biocompatibility. Compared to bone allografts, the Zn-Li scaffolds significantly improved osseointegration adjacent to the transverse processes, which led to enhanced segmental stability of the fused vertebrae post posterolateral lumbar fusion. Overall, the results show that the biodegradable Zn-Li scaffold holds substantial potential as the next-generation graft for spinal fusion.