Reconstruction of Vertebral Bone Defects using an Expandable Replacement Device and Bioactive Glass S53P4 in the Treatment of Vertebral Osteomyelitis: Three Patients and Three Pathogens

Kankare, Jyrki; Lindfors, Nina

doi:10.1177/1457496915626834

Cited by 28 publications

(19 citation statements)

References 24 publications

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“…BAG S53P4 has been studied clinically in randomised prospective trials in bone tumour [27,28], trauma [29] and spine surgery [30,31]. Due to its antibacterial properties is has also been used in the treatment of severe chronic osteomyelitis, mastoiditis, spine infections and frontal sinus infections [21,[32][33][34][35][36][37][38].…”

Section: Introductionmentioning

confidence: 99%

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

Stoor¹,

Frantzén²

2017

Biomedical Glasses

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Bacterial infection of bone tissue and bone marrow, referred to as osteomyelitis, is a challenging clinical problem. In this study we analysed the influence of the granule size of the bone substitute bioactive glass (BAG) S53P4 and the novel putty material containing BAG S53P4 on four clinically important bacteria associated with osteomyelitis; Staphylococcus aureus, methicillin resistant Staphylococuus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa. Reference materials were the frequently used biomaterial in surgical bone grafting procedures; tricalcium phosphate and an inert glass. Powder of BAG S53P4 was used as a positive control. The materials were incubated with bacterial suspension and the viability of the microbes was determined as colony forming units after cultivation on agar plates. All pathogens lost their viability in contact with the BAG S53P4 granules and the powder of the BAG S53P4. The reference materials tricalcium phosphate and the inert glass had no effect on the viability of the bacteria. The BAG S53P4 putty containing 0.5-0.8 mm granules did not show any antibacterial effect on any of the tested bacteria. New putty compositions need to be investigated to obtain antibacterial properties for this novel bone regeneration biomaterial.

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Section: Introductionmentioning

confidence: 99%

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

Stoor¹,

Frantzén²

2017

Biomedical Glasses

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“…Although conservative treatment may allow satisfactory bone healing in some cases, surgical management is indispensably essential, specifically in the severe cases of critical-sized or large bony defect and in vertebral osteomyelitis. Alternative treatment strategy and approach using different bioartificial graft substitutes and materials need to be developed and discovered since the standard procedure using autologous bone grafts was associated with major drawbacks [ 2 , 5 , 6 ]. In this study, we evaluated the outcome of umbilical cord mesenchymal stem cell application combined with hydroxyapatite-based scaffolds (Bongros®) in the treatment of vertebral bone defect due to spondylitis tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Integration of Umbilical Cord Mesenchymal Stem Cell Application in Hydroxyapatite-Based Scaffolds in the Treatment of Vertebral Bone Defect due to Spondylitis Tuberculosis: A Translational Study

Rahyussalim

Nugroho

Zufar

et al. 2021

Stem Cells International

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Background. Vertebral bone defect represents one of the most commonly found skeletal problems in the spine. Progressive increase of vertebral involvement of skeletal tuberculosis (TB) is reported as the main cause, especially in developed countries. Conventional spinal fusion using bone graft has been associated with donor-site morbidity and complications. We reported the utilization of umbilical cord mesenchymal stem cells (UC-MSCs) combined with hydroxyapatite (HA) based scaffolds in treating vertebral bone defect due to spondylitis tuberculosis. Materials and Methods. Three patients with tuberculous spondylitis in the thoracic, thoracolumbar, or lumbar region with vertebral body collapse of more than 50 percent were included. The patient underwent a 2-stage surgical procedure, consisting of debridement, decompression, and posterior stabilization in the first stage followed by anterior fusion using the lumbotomy approach at the second stage. Twenty million UC-MSCs combined with HA granules in 2 cc of saline were transplanted to fill the vertebral bone defect. Postoperative alkaline phosphatase level, quality of life, and radiological healing were evaluated at one-month, three-month, and six-month follow-up. Results. The initial mean ALP level at one-month follow-up was 48.33 ± 8.50 U / L . This value increased at the three-month follow-up but decreased at the six-month follow-up time, 97 ± 8.19 U / L and 90.33 ± 4.16 U / L , respectively. Bone formation of 50-75% of the defect site with minimal fracture line was found. Increased bone formation comprising 75-100% of the total bone area was reported six months postoperation. A total score of the SF-36 questionnaire showed better progression in all 8 domains during the follow-up with the mean total score at six months of 2912.5 ± 116.67 from all patients. Conclusion. Umbilical cord mesenchymal stem cells combined with hydroxyapatite-based scaffold utilization represent a prospective alternative therapy for bone formation and regeneration of vertebral bone defect due to spondylitis tuberculosis. Further clinical investigations are needed to evaluate this new alternative.

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“…To date, no bacterial resistance to S53P4 bioactive glass has been reported and Drago et al showed that S53P4 bioactive glass is even active against multidrug resistant bacterial strains 39,40 . There is also some very preliminary data on activity of S53P4 bioactive glass against Candida albicans, a fungus responsible for some bone infections 41,42 . Interestingly, both mechanisms are detrimental for prokaryotic structures, like bacteria, but not so for eukaryotic cells 43,44 …”

Section: Cierny Stage III and Iv Osteomyelitismentioning

confidence: 99%

“…39,40 There is also some very preliminary data on activity of S53P4 bioactive glass against Candida albicans, a fungus responsible for some bone infections. 41,42 Interestingly, both mechanisms are detrimental for prokaryotic structures, like bacteria, but not so for eukaryotic cells. 43,44 The Tissue response towards the material is also enhanced when compared to hydroxyapatite alone.…”

Section: Cierny Stage III and Iv Osteomyelitismentioning

confidence: 99%

Use of contemporary biomaterials in chronic osteomyelitis treatment: Clinical lessons learned and literature review

Geurts

Vugt

Arts

2020

Journal Orthopaedic Research

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Chronic osteomyelitis has always been a therapeutic challenge for patient and surgeon due to the specific problems related with bone infection and bacterial biofilm eradication. Other than being the cause of infection or facilitating spread or persistence of infection, biomaterials are also becoming a tool in the treatment of infection. Certain novel biomaterials have unique and ideal properties that render them perfectly suited to combat infection and are therefore used more and more in the treatment of chronic bone infections. In case of infection treatment, there is still debate whether these properties should be focused on bone regeneration and/or their antimicrobial properties. These properties will be of even greater importance with the challenge of emerging antimicrobial resistance. This review highlights indications for use and specific material properties of some commonly used contemporary biomaterials for this indication as well as clinical experience and a literature overview.

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Reconstruction of Vertebral Bone Defects using an Expandable Replacement Device and Bioactive Glass S53P4 in the Treatment of Vertebral Osteomyelitis: Three Patients and Three Pathogens

Cited by 28 publications

References 24 publications

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

Integration of Umbilical Cord Mesenchymal Stem Cell Application in Hydroxyapatite-Based Scaffolds in the Treatment of Vertebral Bone Defect due to Spondylitis Tuberculosis: A Translational Study

Use of contemporary biomaterials in chronic osteomyelitis treatment: Clinical lessons learned and literature review

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