Evaluation of bone‐grafting materials in a new canine segmental spinal fusion model

Muschler, George F.; Huber, Bryan; Ullman, Thomas; Barth, Richard W.; Easley, Kirk A.; Otis, James O.; Lane, Joseph M.

doi:10.1002/jor.1100110406

Cited by 61 publications

(29 citation statements)

References 17 publications

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“…The osteoconductive nature of graft materials fabricated from either component alone, or in combination, is well documented (Zerwekh et al, 1992;Muschler et al, 1993;Hollinger et al, 1996). We have developed an osteoconductive matrix composed of mineralized type I collagen fibers that are fabricated into a three-dimensional matrix that mimics the composition and architecture of natural bone (Healos).…”

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confidence: 99%

Spinal fusion with recombinant human growth and differentiation factor‐5 combined with a mineralized collagen matrix

2001

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The availability of recombinant osteoinductive growth factors and new osteoconductive matrices offers an alternative to the use of autogenous bone (autograft) for grafting indications. This study evaluates the bone-forming activity of a mineralized collagen matrix combined with recombinant human growth and differentiation factor-5 in a rabbit posterolateral spinal fusion model. The activity of three distinct matrix-growth factor formulations is assessed by radiographic, histologic, and mechanical strength methods. Results show that the radiographic density, histologic quality, and mechanical strength of fusion at 12 weeks post-treatment rank consistently within the treatment groups. Optimal formulations are shown to perform similar to autograft in both the rate and strength of fusion. Fusion rates as high as 80% are observed within specific matrix/growth factor formulations. The average biomechanical strength of treated motion segments in the most efficacious formulation is 82% higher than that obtained with autograft, although this difference is not statistically significant. The fusion mass formed in response to matrix/ growth factor formulations is composed of normal trabecular bone with a thin outer cortical plate and modest hematopoietic bone marrow. These results demonstrate that the combination of a mineralized collagen matrix with recombinant human growth and differentiation factor-5 maximizes the inherent conductive and inductive properties of each component, respectively, to provide an effective alternative to autograft for bone grafting procedures. Anat The formation of a solid arthrodesis in spine surgery requires the orthotopic formation of bone between the transverse process, facet joint and vertebral body of adjacent motion segments. Traditional spinal fusion procedures utilize autogenous bone (autograft) as a graft to provide the osteogenic, osteoinductive, and osteoconductive components necessary for the formation of new bone at the operative site. Complications associated with the harvest of autograft, such as donor site morbidity, blood loss, and increased operative time, have prompted the search for suitable alternatives (Younger and Chapman, 1989). New bone graft materials are being designed to incorporate or mimic one or more of the bone-forming components of autograft. A common strategy is to combine a purified, recombinant form of an osteoinductive protein with an osteoconductive matrix to attract, stimulate, and support the formation of new bone by host osteogenic cells (Cook et al

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Spinal fusion with recombinant human growth and differentiation factor‐5 combined with a mineralized collagen matrix

2001

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“…At 12 months, histologic quantification of bone ingrowth, as well as results from biomechanical testing, was similar in both groups. Muschler et al compared posterior fusions in a dog segmental posterior spinal fusion model using autograft, collagen/ceramic composite, collagen/ceramic/autograft composite, and no graft material [22]. Autograft bone alone was the most effective graft material tested, and had a statistically superior union score.…”

Section: Ha/tcp Use As Composite or As Carrier Systems In Animal Modelsmentioning

confidence: 99%

Use of hydroxyapatite in spine surgery

Spivak¹,

Hasharoni²

2002

The Use of Bone Substitutes in Spine Surgery

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“…Correction of leg length deformities, management of orthopaedic trauma, and treatment of orthopaedic malignancies would all benefit from improvements in the ability to gcnerate bone tissue. Currently, reconstruction of these skeletal deficits is most often achieved by aulogenous bone grafting (17,35,36). Although this technique is effective at healing small defects, its use to treat larger deficits that result from trauma or tumor resection is limited by the number of harvest sites available to the surgeon.…”

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confidence: 99%

“…have become less desirable as concerns about graft resorption. poor revascularization, and transmission of infectious agents have increased (17,35,36). This has led orthopaedic scientists and surgeons alike to search for new ways to enhance new bonc lormation and repair.…”

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confidence: 99%

Marrow‐derived progenitor cell injections enhance new bone formation during distraction

Richards

Huibregtse

Caplan

et al. 1999

Journal Orthopaedic Research

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Summary: Bilateral femoral distraction was performed in rats to investigate whether injections of marrowderived mesenchymal progenitor cells could be used to facilitate new bone formation. The cells were isolated from whole marrow of 2-6-month-old Sprague-Dawley rats. One-year-old recipient Sprague-Dawley rats were divided into five experimental groups. Rats in groups I. IT, aiid IT1 received injections of mesenchymal progenitor cells on days 6 (beginning), 12 (middle), and 18 (end of distraction) after surgery, respectively. Those in group IV received injections of serum and carrier gel alone, and those in group V received no injections. Distraction zones were harvested at 36 days and analyzed for new bone volume within the distraction gap by three-dimensional microcomputed tomography. Significant increases in new bone volume were observed for femora injected with marrow-derived progenitor cells compared with contralateral femora and controls (no injection). The timing ol the cell injections appeared to have no effect on the experimental outcome. Histologic analyses demonstrated active formation of new trabecular bone with marked osteoblastic activity and osteoid production. No qualitative differences in histologic appearances of new bone among rats in any of the five groups were seen. The results of in vitro lysis assays indicated that donor and recipient rats were not completely syngenic, leaving some doubt as to the reasons Lor observed increases in new bone formation. Future work will locus on attempting to repeat these experiments in a fully syngenic rat model. This rat distraction model can be uscd to explore the molecular and cellular behavior of these progenitor cells in a clinically relevant in vivo environment.

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Evaluation of bone‐grafting materials in a new canine segmental spinal fusion model

Cited by 61 publications

References 17 publications

Spinal fusion with recombinant human growth and differentiation factor‐5 combined with a mineralized collagen matrix

Spinal fusion with recombinant human growth and differentiation factor‐5 combined with a mineralized collagen matrix

Use of hydroxyapatite in spine surgery

Marrow‐derived progenitor cell injections enhance new bone formation during distraction

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