Application of Resorbable Poly(Lactide-co-Glycolide) with Entangled Hyaluronic Acid as an Autograft Extender for Posterolateral Intertransverse Lumbar Fusion in Rabbits

Abstract

Facilitating fusion between bony segments in a reliable and reproducible manner using a synthetic bone graft material has a number of benefits for the surgeon as well as the patient. Although autograft remains the gold standard, associated comorbidities continue to drive the development of new biomaterials for use in spinal fusion. The ability of autograft alone and autograft combined with a radiolucent biomaterial composed of resorbable osteoconductive poly(lactide-co-glycolide) with entangled hyaluronic acid to facilitate fusion was examined in a single-level noninstrumented posterolateral intertransverse lumbar fusion model in New Zealand White rabbits. Progressive bone formation was demonstrated radiographically for the extender group (synthetic biomaterial plus autograft) between 3 and 6 months. Computed tomography revealed a new cortical shell in the fusion mass at 3 and 6 months for both study groups. Tensile testing at 6 months demonstrated that the quality of bone formed between the intertransverse space was equivalent for both study groups. Histologic evaluation of the fusion mass revealed new bone on and adjacent to the transverse processes with the synthetic biomaterial group that extended laterally, supporting the osteoconductive nature of the material. Histological evidence of endochondral bone growth in the intertransverse space was observed for the autograft plus synthetic biomaterial group. Bone remodeling, new marrow spaces, and peripheral cortices were observed for each study group at 3 months that matured by 6 months. These findings support the use of a radiolucent biosynthetic material comprising poly(lactide-co-glycolide) with integrated hyaluronic acid as an autograft extender for lumbar intertransverse fusion.

Evaluation of Posterolateral Lumbar Fusion in Sheep Using Mineral Scaffolds Seeded with Cultured Bone Marrow Cells

“…The accumulation of data on the anti-inflammatory and immunomodulatory roles of MSCs when they are implanted (or injected) in various situations indicates that MSCs would not promote the call of phagocytic cells at the implant site, conversely preventing it [ 41 , 42 ]. Although implanted cells in the same surgical procedure must be right, our observations suggest that perhaps there is a demolition phase before bone formation, with the participation of macrophages and osteoclasts, as has been proposed [ 43 ]. In a study carried out not long ago, researchers significantly improved the ossification of a tibial defect by injecting endothelial progenitors two weeks after wound healing began [ 44 ].…”

Within Patient Radiological Comparative Analysis of the Performance of Two Bone Graft Extenders Utilized in Posterolateral Lumbar Fusion: A Retrospective Case Series

“…Histological observation of sham defects in rabbits revealed an abnormal fatty appearance to the marrow space occupying these defects, with a futile attempt at revascularization. Further confirmation of this mechanism of action was recently obtained in the Boden model for posterolateral lumbar fusion using a mixture of InQu granules and ICBG (50:50 ratio) ( 31 ). Vascularization of a cartilage intermediate was accompanied histologically by calcification of the cartilage matrix, which ultimately was replaced by woven bone from invading osteoprogenitor cells originating from the vasculature ( 31 ).…”

Promoting Endochondral Bone Repair Using Human Osteoarthritic Articular Chondrocytes

“…Color images available online at www.liebertpub.com/tea ‰ ENGINEERED ENDOCHONDRAL CARTILAGE GRAFTS matrix with bone autograft promotes endochondral ossification in a rabbit model of spinal fusion. 31 In conclusion, we have shown that hOA articular chondrocytes from total joint arthroplasty resections can be transformed into endochondral tissues that promote bone formation in vivo. These grafts are able to integrate with host bone, undergo vascularization, and heal critical-size longbone defects in mice.…”