Lumbar Spinal Fusion Using Recombinant Human Bone Morphogenetic Protein in the Canine

David, Stephen M.; Gruber, Helen E.; Meyer, Ralph A.; Murakami, Takanori; Tabor, Owen B.; Howard, Brian A.; Wozney, John M.; Hanley, Edward N.

doi:10.1097/00007632-199910010-00002

Cited by 90 publications

(39 citation statements)

References 28 publications

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“…Lytic zones resulting from polymer hydrolysis [41] or degradation-induced inflammation and bone resorption [42] were observed in canine models with scaffolds made of poly(L-lactic-co-glycolic acid) associated with BMP-2. In this study, although local bone degradation could have occurred, radiopacity of X-rays was increasing in a time-dependent fashion with all scaffold groups made of PLA indicating rather bone formation than resportion.…”

Section: Discussionmentioning

confidence: 99%

Human fetal bone cells associated with ceramic reinforced PLA scaffolds for tissue engineering

Montjovent

Mark

Mathieu

et al. 2008

Bone

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Fetal bone cells were shown to have an interesting potential for therapeutic use in bone tissue engineering due to their rapid growth rate and their ability to differentiate into mature osteoblasts in vitro. We describe hereafter their capability to promote bone repair in vivo when combined with porous scaffolds based on poly(L-lactic acid) (PLA) obtained by supercritical gas foaming and reinforced with 5 wt.% β-tricalcium phosphate (TCP).Bone regeneration was assessed by radiography and histology after implantation of PLA/TCP scaffolds alone, seeded with primary fetal bone cells, or coated with demineralized bone matrix. Craniotomy critical size defects and drill defects in the femoral condyle in rats were employed. In the cranial defects, polymer degradation and cortical bone regeneration were studied up to 12 months postoperatively. Complete bone ingrowth was observed after implantation of PLA/TCP constructs seeded with human fetal bone cells. Further tests were conducted in the trabecular neighborhood of femoral condyles, where scaffolds seeded with fetal bone cells also promoted bone repair.We present here a promising approach for bone tissue engineering using human primary fetal bone cells in combination with porous PLA/TCP structures. Fetal bone cells could be selected regarding osteogenic and immune-related properties, along with their rapid growth, ease of cell banking and associated safety.

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Section: Discussionmentioning

confidence: 99%

Human fetal bone cells associated with ceramic reinforced PLA scaffolds for tissue engineering

Montjovent

Mark

Mathieu

et al. 2008

Bone

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“…The expression of GDF-5 is required for proper skeletal patterning and joint development in the vertebrate limb, and null mutations result in brachydactyly syndromes in both animals and man (Storm et al, 1994;Polinkovsky et al, 1997). Based on the sequence homology to other BMP family members that have been shown to be effective in posterolateral spine fusion models (Cook et al, 1994;Muschler et al, 1994;Boden et al, 1995bBoden et al, , 1999Holliger et al, 1996;Sandhu et al, 1997;David et al, 1999;Martin et al, 1999;Minamide et al, 1999), the activity of a recombinant form of human in combination with mineralized collagen matrix formulations is examined here in a well-characterized rabbit spine fusion model.…”

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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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“…PLDLLA degrades in a number of ways through chemical, thermal, mechanical and physical mechanisms [10] of these the chemical degradation is the most important and is primarily through hydrolysis and metabolism in the citric acid cycle [10]. Disintegration of the PLDLLA cages into multiple fragments and initial absorption of small PLDLLA fragments are observed 1 year after the implantation.…”

Section: Discussionmentioning

confidence: 99%

Osteolysis following resorbable poly-l-lactide-co-d, l-lactide PLIF cage use: a review of cases

et al. 2011

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Study design Report of case seriesObjective To report a problem with bioabsorbable poly-Llactide-co-D, L-lactide, PLDLLA, posterior lumbar instrumented fusion (PLIF) cage implants. Summary of background data Synthetic bioabsorbable implants have recently been introduced to spinal surgery and their indications and applications are still being explored. There is evidence that the use of bioabsorbable cages may be of benefit in interbody spinal fusion. Methods We present a case series of nine patients who have undergone PLIF with bioabsorbable cages in the lumbar spine. Results At follow-up over at least 1 year, four of these patients were found to have osteolysis around the implant on CT scanning. One of these patients underwent an operation to remove the cage and histology sent during surgery suggested that the implant had caused the bone loss and there was no evidence of infection. Another patient had ongoing pain in relation to the lysis, while the other two patients with lysis remained asymptomatic. Conclusions PLDLLA cage, which has high osteolytic nature, is considered not suitable as a fusion cage.

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Lumbar Spinal Fusion Using Recombinant Human Bone Morphogenetic Protein in the Canine

Abstract: The use of recombinant human bone morphogenetic protein 2 implanted using a Type I collagen carrier resulted in 100% fusion without adverse effects.

Cited by 90 publications

References 28 publications

Human fetal bone cells associated with ceramic reinforced PLA scaffolds for tissue engineering

Human fetal bone cells associated with ceramic reinforced PLA scaffolds for tissue engineering

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

Osteolysis following resorbable poly-l-lactide-co-d, l-lactide PLIF cage use: a review of cases

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