Treatment of Pseudoarthrosis Using Tissue-Engineered Bone Graft

Abstract

Subjects were graft patients with pseudoarthrosis (average age, 60.3 years; range, 17-85 years). Pseudoarthrosis affected the thoracolumbar spine, the femur, the clavicle, the humerus and the metatarsal. From the ilium (tibia in one patient), 10-20 ml of bone marrow fluid was collected, and then, it was immediately transferred to the culture room and incubated in a flask containing MEM with 15% autologous or fetal bovine serum, etc.. After 2 weeks in primary culture, cells were released by trypsin treatment and were subsequently incubated with porous beta-TCP in order to prepare tissue-engineered artificial bone, according to the previously reported modified culturing technique. Tissue-engineered artificial bone was grafted around the non-union site of each affected long bone, while tissue-engineered artificial bone was grafted via the pedicle of each affected vertebral body. In all patients, favorable bone formation was seen at three months after surgery. In the patients with pseudoarthrosis of the spine, CT and MRI confirmed favorable vertebral body formation. In the patients with pseudoarthrosis of a long bone, the artificial bone was remodeled and favorable bone union was confirmed. In 2 patients in whom bone biopsy was performed during pin removal, bone regeneration was confirmed histologically. With present type of tissue-engineered artificial bone, an artificial material with a high bone regeneration capacity can be prepared by aspiration, which is minimally invasive, and thus when compared to iliac bone grafts, it is possible to radically reduce postoperative pain without damage of autologous bone.

Disc Regeneration Therapy Using Marrow Mesenchymal Cell Transplantation

“…44 -51 With approval of the university's Ethics Review Board, we have performed therapeutic regeneration therapy of various tissues in clinical settings. [39][40][41][42][43] The present intervertebral disc regeneration therapy using MSC brought about favorable results in these 2 cases. The present therapy can be performed through an incision of about 5 mm, and seems to be a promising minimally invasive treatment.…”

“…This is a convenient technique that does not require specialized equipment or complex procedures, such as long-term collagenase treatment. There have already been clinical reports on tissue regeneration therapy using MSCs, [37][38][39][40][41][42][43] and such techniques are practical.…”