Utilization of type I collagen gel, demineralized bone matrix, and bone morphogenetic protein-2 to enhance autologous bone lumbar spinal fusion

Abstract

Autologous bone grafts are currently considered "gold standard" material for achieving long-term spinal arthrodesis. The present study was performed to determine whether demineralized bone matrix (DBM), type I collagen gels, or bone morphogenetic protein-2 (BMP-2) can improve autologous bone spinal fusions. Using a unilateral decompression-contralateral fusion technique in dogs, each of these materials was added to an autologous bone graft. Volumetric analysis, histological analysis, and biomechanical testing were performed to assess the effectiveness of each material. The DBM had an inhibitory effect on solid bone fusion of the spine, whereas the type I collagen gels improved the bony interface between the graft and the host spine. The BMP-2 strongly enhanced the amount of bone deposition at the fusion site and increased the number of intervertebral levels that were solidly fused. This study strongly supports the use of BMP-2 as an additive to autologous bone grafts in spine stabilization.

Spinal fusion using an autologous growth factor gel and a porous resorbable ceramic

“…Augmentation of spinal fusion has been examined using BMPs [4, 5, 6, 7, 8, 13, 23, 35, 46], demineralised bone [26] as well as non-invasive techniques of ultrasound [21] or pulsed electromagnetic fields [28,30]. Collectively, these studies and many others support the concept of stimulating or accelerating healing through the application of a single molecule, non-invasive stimulation and more recently gene therapy.…”

A Comparative Evaluation of Factors Influencing Osteoinductivity Among Scaffolds Designed for Bone Regeneration

“…23 This effect likely renders ACS unable to ensure longerterm growth factor delivery and has been postulated to contribute to the adverse effects associated with the use of rhBMP-2/ACS clinically. [24][25][26] Relative to all other scaffolds, the S(P) gel showed a superior rate of initial growth factor binding, followed by a steady and sustainable release over the period studied. In comparing ACS and the S(P) gel, it is important to note that in a rat spinal arthrodesis model, we have observed ACS to be completely degraded by day 7, whereas the S(P) gel is biodegraded by approximately day 21 in vivo (data not shown).…”

Osteogenic efficiency of in situ gelling poloxamine systems with and without bone morphogenetic protein-2

“…Osteogenic effi ciency of poloxamines initial burst release (Helm et al, 1997;Takahashi et al, 2005). Alternative materials such as gelatin/-tricalcium phosphate (Yang et al, 2005), poly(L-lactic acid) (PLA) , poly(L-lactic-co-glycolic acid) (PLGA) (Jeon et al, 2007;Shen et al, 2009), hyaluronic acid (Kim and Valentini, 2002), fi brin gel (Itosaka et al, 2009) or porous hydroxyapatite composites (Sopyana et al, 2007) are under study.…”