Evaluation of rhBMP-2 With an OPLA Carrier in a Canine Posterolateral (Transverse Process) Spinal Fusion Model
| Autor: | J. M. Kabo, Edgar G. Dawson, Jeffrey M. Toth, D. Liu, L L Seeger, E N Zeegan, Linda E.A. Kanim, Harvinder S. Sandhu |
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| Rok vydání: | 1995 |
| Předmět: |
recombinant human bone morphogenetic protein-2
medicine.medical_specialty Bone Regeneration Polymers medicine.medical_treatment Clinical Sciences Long bone Biomedical Engineering canine Lumbar vertebrae Acetates Bone morphogenetic protein Iliac crest Ilium Dogs bone morphogenetic protein medicine Animals Humans Orthopedics and Sports Medicine Growth Substances Bone regeneration Tomography Acetic Acid Drug Carriers Lumbar Vertebrae Bone Transplantation Demineralized bone matrix business.industry Proteins polylactic acid polymer medicine.disease posterolateral fusion Recombinant Proteins X-Ray Computed Surgery Pseudarthrosis Spinal Fusion Orthopedics medicine.anatomical_structure Evaluation Studies as Topic Spinal fusion Bone Morphogenetic Proteins bone induction Female Neurology (clinical) Tomography X-Ray Computed business |
| Zdroj: | Spine, vol 20, iss 24 Sandhu, HS; Kanim, LEA; Kabo, JM; Toth, JM; Zeegen, EN; Liu, D; et al.(1995). Evaluation of rhBMP-2 with an OPLA carrier in a canine posterolateral (transverse process) spinal fusion model. SPINE, 20(24), 2669-2682. doi: 10.1097/00007632-199512150-00008. UCLA: Retrieved from: http://www.escholarship.org/uc/item/1c78t4s6 Europe PubMed Central |
| ISSN: | 0362-2436 |
| DOI: | 10.1097/00007632-199512150-00008 |
| Popis: | SPINE Volume 20, Number 24, pp 2669-2682 @1995, Lippincott—Raven Publishers Evaluation of rhBMP-2 With an OPLA Carrier in a Canine Posterolateral (Transverse Process) Spinal Fusion Model Harvinder S. Sandhu, MD,* Linda E. A. Kanim, MA,* J. Michael Kabo, PhD,* Jeffrey M. Toth, PhD,i Erik N. Zeegen, BA,* David Liu,* Leanne L. Seeger, MD,T and Edgar G. Dawson, MD* Study Design. Posterolaterai l.4—L5 transverse pro- cess fusions were done on 14 adult beagles. Six were implanted with recombinant human bone morphoge- netic protein-2 carried by open-cell polylactic acid poly- mer delivery vehicle. Six received autogenous iliac bone graft. Two received carrier alone. Eleven were killed 3 months after implantation. One in each group was maintained for 8 months. Objectives. To compare recombinant human bone morphogenetic protein-2 and open-cell polvlactlc acid polymer with autogenous iliac bone for inducing trans- verse process fusion in the canine by 3 months and to determine whether transverse process decortication and implantation of carrier alone causes spontaneous transverse process fusion in the canine. Summary of Background Data. Recombinant human bone morphogenetic proteins have healed segmental long bone defects in several models. They have in- duced interlaminar and facet fusions in canines. Inter- Iaminar and facet fusions have occurred after sham decortications in canines. Recombinant human bone morphogcnetic protein-2 has not been evaluated for transverse process fusion in canines. Transverse pro- cess fusion is a preferred clinical method for achieving posterior lumbar fusion. Methods. Fusion sites were evaluated by serial com- puted tomography scans. After the dogs were killed, explanted spines were subjected to manual testing, me- chanical testing, high resolution radiography, and histo- Iogic analysis. Results. One hundred percent of recombinant hu- man bone morphogenetic protein-2-implanted sites had solid transverse process fusion oy 3 months according From the “Department of Orthopaedic Surgery and the '|'Department of Radiology, UCLA School of Medicine, Los Angelcs, California, and the :tDepartment of Orthopaedic Surgery, The Medical College of Wisconsin, Milwaukee, Wisconsin. Funding provided by Sofamor Danek USA, Memphis, Tennessee, and Genetics Institute, Andover, Massachusetts. Presented in part at the Scoliosis Research Society, Portland, Oregon, September 1994. Accepted for publication May 15, 1995. Device status category: 7. to all measures. No autografted sites were fused at this interval. Ossoous bridging of posteroiateral gutters oc- curred in the recombinant human bone morphogenetic protein-2-implanted sites after 2 months, the earliest radiographic measure. None of the carrier-only sites showed bone formation. conclusions. Recombinant bone morphogcnetlc pro- tein-2 carried by open-cell polylactic acid polymer is superior to autogenous iliac bone for producing radio- graphically and mechanically solid transverse process fusions in canines by 3 months. Spontaneous trans- verse process fusion does not occur in canines after decortication and open-cell polylactic acid polymer im- plantation. [Key words: bone induction. bone morpho- genetic protein. canine. polylactic acid polymer, pos- tcrolateral fusion. recombinant human bone morphogenetic protein-2| Spine 1995:20:2669-2682 Posterolateral transverse process fusion (TPF)is a fre- quently used method for achieving primary lumbar intersegmental arthrodesis.” Autogenous corticocan- cellous bone chips from the iliac crest, combining osteo- genic, osteoconductive, and osteoinductive properties, are currently the most successful grafting material.15’18 The incidence of pseudarthrosis with use of autogenous bone has been reported as high as 40% for multilevel fusions.3 Additional disadvantages with iliac crest graft relate to the adjuvant procedure required to procure the graft. Younger and Chapman noted minor complications such as harvest site pain, hypersensitivity, and buttocks an- esthesia in 20.6% of patients and major complications such as deep infections and vascular injuries in 8.6% of patients.7'”'39 Fresh, frozen, lyophilized, and demineralized bone matrix from allogeneic sources are used as alternatives or supplements to autogenous bone.21’22'28 These prep- arations are impaired by lower osteogenic capacity, higher resorption rate, larger host immunologic re- sponse, and reduced revascularization.” There are con- 2669 |
| Databáze: | OpenAIRE |
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