Efficacy of Mesenchymal Stem Cell Enriched Grafts in an Ovine Posterolateral Lumbar Spine Model

Study Design. Four groups of 6 animals underwent single-level noninstrumented posterolateral lumbar fusion (PLF) with one of the following grafts: 1) autograft, 2) cell-enriched &bgr;-tricalcium phosphate (TCP), 3) TCP with whole bone marrow, and 4) TCP alone. Plain radiographs were taken after surgery and at death, 6 months after surgery. Explanted spine segments were analyzed by manual palpation, micro-CT, and histology. Objective. A sheep spine fusion study was undertaken to evaluate the healing performance of a TCP graft enriched with osteoprogenitor cells using Selective Cell Retention technology (SCR), compared with autograft, TCP with whole bone marrow, and TCP alone. Summary of Background Data. Improved bone healing with previously demonstrated using grafts enriched in osteoprogenitor cells. Methods. Cell-enriched grafts were obtained by processing 30 mL of bone marrow through 10 mL of TCP. TCP was also used either saturated with bone marrow or alone. Results. At 6 months, 33% of the SCR-enriched TCP and 25% of the autograft sites were fused, compared with 8% of the TCP plus whole bone marrow and 0% of the TCP alone. Histology of fused samples showed denser bone formation in the SCR-enriched TCP grafts than in the autograft sites. Conclusions. The use of SCR-enriched TCP and autograft resulted in similar fusion rates in an ovine posterolateral noninstrumented lumbar spine fusion model.

[1]  H. Precheur Bone graft materials. , 2007, Dental clinics of North America.

[2]  F Beaujean,et al.  Percutaneous autologous bone-marrow grafting for nonunions. Influence of the number and concentration of progenitor cells. , 2005, The Journal of bone and joint surgery. American volume.

[3]  B. Weiner,et al.  Efficacy of Autologous Growth Factors in Lumbar Intertransverse Fusions , 2003, Spine.

[4]  W. Davros,et al.  Spine Fusion Using Cell Matrix Composites Enriched in Bone Marrow-Derived Cells , 2003, Clinical orthopaedics and related research.

[5]  R. Midura,et al.  Connective tissue progenitors: practical concepts for clinical applications. , 2002, Clinical orthopaedics and related research.

[6]  J. Poser,et al.  Spinal fusion with recombinant human growth and differentiation factor‐5 combined with a mineralized collagen matrix , 2001, The Anatomical record.

[7]  J E Block,et al.  Surgical harvesting of bone graft from the ilium: point of view. , 2000, Medical hypotheses.

[8]  G. Muschler,et al.  Bone cells and matrices in orthopedic tissue engineering. , 2000, The Orthopedic clinics of North America.

[9]  J. Block,et al.  Clinical Indications of Calcium-Phosphate Biomaterials and Related Composites for Orthopedic Procedures , 2000, Calcified Tissue International.

[10]  G. Muschler,et al.  Bone graft materials. An overview of the basic science. , 2000, Clinical orthopaedics and related research.

[11]  M. Bostrom,et al.  Biosynthetic bone grafting. , 1999, Clinical orthopaedics and related research.

[12]  S. Bruder,et al.  Tissue engineering of bone. Cell based strategies. , 1999, Clinical orthopaedics and related research.

[13]  V. Pellegrini,et al.  A comparison of the vastus splitting and median parapatellar approaches in total knee arthroplasty. , 1999, Clinical orthopaedics and related research.

[14]  G. Lowery,et al.  Use of autologous growth factors in lumbar spinal fusion. , 1999, Bone.

[15]  B. Cole,et al.  Bone marrow and recombinant human bone morphogenetic protein-2 in osseous repair. , 1999, Clinical orthopaedics and related research.

[16]  J. Lotz,et al.  Use of a Collagen‐Hydroxyapatite Matrix in Spinal Fusion: A Rabbit Model , 1998, Spine.

[17]  K. Kraus,et al.  Mesenchymal stem cells in osteobiology and applied bone regeneration. , 1998, Clinical orthopaedics and related research.

[18]  J. Lane,et al.  Current understanding of osteoconduction in bone regeneration. , 1998, Clinical orthopaedics and related research.

[19]  J. Connolly Clinical use of marrow osteoprogenitor cells to stimulate osteogenesis. , 1998, Clinical orthopaedics and related research.

[20]  R. Marx,et al.  Platelet-rich plasma: Growth factor enhancement for bone grafts. , 1998, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[21]  C. Boehm,et al.  Aspiration to Obtain Osteoblast Progenitor Cells from Human Bone Marrow: The Influence of Aspiration Volume* , 1997, The Journal of bone and joint surgery. American volume.

[22]  M. Chapman,et al.  Treatment of Acute Fractures with a Collagen-Calcium Phosphate Graft Material. A Randomized Clinical Trial*† , 1997, The Journal of bone and joint surgery. American volume.

[23]  J. Connolly,et al.  The role of a composite, demineralized bone matrix and bone marrow in the treatment of osseous defects. , 1995, Orthopedics.

[24]  A. Levine,et al.  Chronic Donor Site Pain Complicating Bone Graft Harvesting From the Posterior Iliac Crest for Spinal Fusion , 1992, Spine.

[25]  B. Summers,et al.  Donor site pain from the ilium. A complication of lumbar spine fusion. , 1989, The Journal of bone and joint surgery. British volume.

[26]  J. Connolly,et al.  Development of an osteogenic bone-marrow preparation. , 1989, The Journal of bone and joint surgery. American volume.

[27]  R. Burwell The Function of Bone Marrow in the Incorporation of a Bone Graft , 1985, Clinical orthopaedics and related research.

[28]  J. Woody,et al.  Harvest of human bone marrow directly from bone. , 1984, Journal of immunological methods.

[29]  Gary R. Grotendorst,et al.  Platelet-derived growth factor enhances demineralized bone matrix-induced cartilage and bone formation , 2007, Calcified Tissue International.

[30]  J. Jansen,et al.  Tissue Engineering of Bone , 1997 .