Comparison of Healos/Bone Marrow to INFUSE(rhBMP-2/ACS) With a Collagen-Ceramic Sponge Bulking Agent as Graft Substitutes for Lumbar Spine Fusion

Abstract

From the manual palpation, radiographic and biomechanical assessment of fusion, the results in this study showed that INFUSE (rhBMP-2/collagen sponge) consistently produced spine fusion when wrapped around a collagen-ceramic sponge bulking agent (Mastergraft Matrix). Meanwhile, Healos was ineffective as a bone graft material when combined with heparinized autogenous bone marrow.

The efficacy of porous hydroxyapatite bone chip as an extender of local bone graft in posterior lumbar interbody fusion

“…Its osteoconductive function and qualification as a graft extender were shown in our previous clinical studies compared to those of the autogenous iliac bone graft in human posterolateral fusion of lumbar spine, which is consistent with results from other studies using synthetic hydroxyapatite in posterolateral fusion [13][14][15][16]. However, in interbody fusion, there are contradictory reports on the efficacy of synthetic hydroxyapatite as a graft extender [15][16][17].…”

“…However, it has a limitation as a graft material in that it acts purely as an osteoconductive scaffold and contains neither osteogenic cell nor osteoinductive factor. Hence in another published studies using a spongy-form synthetic hydroxyapatite bone it was recommended to be used in combination with adjuvant osteoinductive materials like bone marrow aspirates or bone morphogenic proteins (BMPs) to make up for its limitation [14][15][16]24]. Neen et al found that a collagenhydroxyapatite spongy with bone marrow aspirate showed equivalent fusion rate in posterolateral gutter but significantly lower fusion rate in interbody space than iliac bone graft, 83-93%.…”

Design of biocomposite materials for bone tissue regeneration

“…It is shown that Healos ® is not an efficient bone graft substitute as lumbar spinal fusions are not achieved in adult New Zealand rabbits [30].…”

2011 AOA Symposium: Tissue Engineering and Tissue Regeneration

“…Data from animal studies would suggest that a bone graft substitute with some level of osteoinductivity is most effective for posterolateral spinal arthrodesis because it can combine the creeping substitution process of bone ingrowth from the decorticated host bone, with recruitment and differentiation of additional progenitor cells from the surrounding soft tissue adding a centripetal pattern of bone-healing 5,6 . Specific BMPs (BMP-2, 4, 6, 7, and 9) have demonstrated the potential for varying degrees of osteoinductivity 7 .…”