In vivo evaluation of calcium sulfate as a bone graft substitute for lumbar spinal fusion

Glazer, Paul A.; Spencer, Upshur M; Alkalay, Ron N.; Schwardt, J.D.

doi:10.1016/s1529-9430(01)00108-5

Cited by 52 publications

(35 citation statements)

References 36 publications

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“…Sato et al further indicated the promising characteristics of gypsum after mixing it with HAp particles, based on the relatively fast absorption of gypsum without interfering with the process of bone healing [15]. In an attempt to use gypsum as a bone graft substitute for lumbar spinal fusion, CSD showed unsuccessful results because of its rapid resorption [16].…”

Section: Introductionmentioning

confidence: 99%

Phase evolution during the low temperature formation of stoichiometric hydroxyapatite-gypsum composites

Greish

2011

Ceramics International

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Section: Introductionmentioning

confidence: 99%

Phase evolution during the low temperature formation of stoichiometric hydroxyapatite-gypsum composites

Greish

2011

Ceramics International

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“…13,14 Calcium phosphate-based HA is well known for its osteoconductive properties; however, studies have revealed that graft materials with osteoconductive properties alone are inadequate to generate new bone at this site. [15][16][17] In its natural form, PRP contains growth factors and other cytokines;…”

Section: Discussionmentioning

confidence: 99%

Histological Evaluation of Hydroxyapatite Granules with and without Platelet-Rich Plasma versus an Autologous Bone Graft: Comparative study of biomaterials used for spinal fusion in a New Zealand white rabbit model

Zakaria

Seman

Buyong

et al. 2016

SQUMJ

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abstract:Objectives: Hydroxyapatite (HA) has osteoconductive properties and is widely used as a bone graft substitute. Platelet-rich plasma (PRP) is an autologous product with osteoinductive effects. Hypothetically, a combination of both would augment the bone formation effect of HA and widen its application in spinal fusion surgeries. This study aimed to compare new bone formation with HA granules alone and in combination with PRP versus an autologous bone graft during a lumbar intertransverse process spinal fusion. Methods: A total of 16 adult New Zealand white rabbits underwent single-level bilateral intertransverse process fusion at the L5-L6 vertebrae. One side of the spine received either HA granules alone or a combination of HA granules and PRP, while the contralateral side received an autologous bone graft. Four animals each from the HA group and the HA plus PRP group versus the autograft group were assessed either at six or 16 weeks by undecalcified histology and histomorphometry. The mean percentage of new bone areas over the corresponding fusion masses were compared between groups. Results: No significant difference in new bone formation was observed between the HA and HA plus PRP groups at six or 16 weeks. The autograft group had significantly more new bone formation at six and 16 weeks (P = 0.004 and <0.001, respectively). Conclusion: An autologous bone graft remains superior to HA granules, with or without PRP. HA granules demonstrated an excellent osteoconductive scaffold but had poor biodegradability. While PRP enhances the properties of HA granules, these biomaterials do not have a synergistic effect.

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“…In comparison, rapid degradation of CaSO 4 can lead to the release of a high local concentration of calcium ions, which, in turn, can lead to changes in the local pH, the activation of a mild inflammatory response, and the inhibition of new bone formation (38)(39)(40). In the present study, it was observed that large amounts of inflammatory cells and fibrosis surrounded the newly formed bone and residual CaSO 4 material in the defects implanted with the TCS pellets, which presumably contributed to inhibiting bone regeneration.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Borate Bioactive Glass and Calcium Sulfate as Implants for the Local Delivery of Teicoplanin in the Treatment of Methicillin-Resistant Staphylococcus aureus-Induced Osteomyelitis in a Rabbit Model

Jia

Huang

et al. 2015

Antimicrob Agents Chemother

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There is growing interest in biomaterials that can cure bone infection and also regenerate bone. In this study, two groups of implants composed of 10% (wt/wt) teicoplanin (TEC)-loaded borate bioactive glass (designated TBG) or calcium sulfate (TCS) were created and evaluated for their ability to release TEC in vitro and to cure methicillin-resistant Staphylococcus aureus (MRSA)-induced osteomyelitis in a rabbit model. When immersed in phosphate-buffered saline (PBS), both groups of implants provided a sustained release of TEC at a therapeutic level for up to 3 to 4 weeks while they were gradually degraded and converted to hydroxyapatite. The TBG implants showed a longer duration of TEC release and better retention of strength as a function of immersion time in PBS. Infected rabbit tibiae were treated by debridement, followed by implantation of TBG or TCS pellets or intravenous injection with TEC, or were left untreated. Evaluation at 6 weeks postimplantation showed that the animals implanted with TBG or TCS pellets had significantly lower radiological and histological scores, lower rates of MRSA-positive cultures, and lower bacterial loads than those preoperatively and those of animals treated intravenously. The level of bone regeneration was also higher in the defects treated with the TBG pellets. The results showed that local TEC delivery was more effective than intravenous administration for the treatment of MRSA-induced osteomyelitis. Borate glass has the advantages of better mechanical strength, more desirable kinetics of release of TEC, and a higher osteogenic capacity and thus could be an effective alternative to calcium sulfate for local delivery of TEC. Bacterial infection resulting from orthopedic surgery is a serious complication. The pathogenic organisms responsible for such infections are often resistant to multiple drugs. Methicillinresistant Staphylococcus aureus (MRSA) has become the most common osteomyelitis-inducing microorganism clinically (1, 2). Currently, the main treatment for chronic osteomyelitis includes surgical debridement and prolonged systemic antibiotic therapy over a course of several weeks. As an antibiotic, teicoplanin (TEC) has a long serum half-life and broad-spectrum antibacterial activity against most Gram-positive aerobic and anaerobic organisms such as MRSA and methicillin-resistant coagulase-negative S. aureus (3). Compared to vancomycin (a more widely used antibiotic), the use of TEC also results in less ototoxicity, nephrotoxicity, and gastrointestinal side effects. Because of its favorable pharmacokinetics, TEC is commonly used in Europe to treat osteomyelitis (4).Even after thorough debridement, residual infection often remains in the bone. The surgical procedure also creates a bone defect that usually requires subsequent reconstruction (5). Furthermore, nidus formation considerably limits the efficacy of systemic antibiotic therapy because of the compromised vascular perfusion at the infected site. High concentrations of antibiotics in the blood resulting from long-t...

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In vivo evaluation of calcium sulfate as a bone graft substitute for lumbar spinal fusion

Cited by 52 publications

References 36 publications

Phase evolution during the low temperature formation of stoichiometric hydroxyapatite-gypsum composites

Phase evolution during the low temperature formation of stoichiometric hydroxyapatite-gypsum composites

Histological Evaluation of Hydroxyapatite Granules with and without Platelet-Rich Plasma versus an Autologous Bone Graft: Comparative study of biomaterials used for spinal fusion in a New Zealand white rabbit model

Comparison of Borate Bioactive Glass and Calcium Sulfate as Implants for the Local Delivery of Teicoplanin in the Treatment of Methicillin-Resistant Staphylococcus aureus-Induced Osteomyelitis in a Rabbit Model

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