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European Spine Journal
Published in: European Spine Journal 4/2004

01-07-2004 | Original Article

Anterior lumbar interbody fusion with carbon fiber cage loaded with bioceramics and platelet-rich plasma. An experimental study on pigs

Authors: Haisheng Li, Xuenong Zou, Qingyun Xue, Niels Egund, Martin Lind, Cody Bünger

Published in: European Spine Journal | Issue 4/2004

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Abstract

Platelet-rich plasma (PRP) is an autogenous source of growth factor and has been shown to enhance bone healing both in clinical and experimental studies. PRP in combination with porous hydroxyapatite has been shown to increase the bone ingrowth in a bone chamber rat model. The present study investigated whether the combination of beta tricalcium phosphate (β-TCP) and PRP may enhance spinal fusion in a controlled animal study. Ten Danish Landrace pigs were used as a spinal fusion model. Immediately prior to the surgery, 55 ml blood was collected from each pig for processing PRP. Three-level anterior lumbar interbody fusion was performed with carbon fiber cages and staples on each pig. Autogenous bone graft, β-TCP, and β-TCP loaded with PRP were randomly assigned to each level. Pigs were killed at the end of the third month. Fusion was evaluated by radiographs, CT scanning, and histomorphometric analysis. All ten pigs survived the surgery. Platelet concentration increased 4.4-fold after processing. Radiograph examination showed 70% (7/10) fusion rate in the autograft level. All the levels with β-TCP+PRP showed partial fusion, while β-TCP alone levels had six partial fusions and four non-fusions (P=0.08). CT evaluation of fusion rate demonstrated fusion in 50% (5/10) of the autograft levels. Only partial fusion was seen at β-TCP levels and β-TCP+PRP levels. Histomorphometric evaluation found no difference between β-TCP and β-TCP+PRP levels on new bone volume, remaining β-TCP particles, and bone marrow and fibrous tissue volume, while the same parameters differ significantly when compared with autogenous bone graft levels. We concluded from our results in pigs that the PRP of the concentration we used did not improve the bone-forming capacity of β-TCP biomaterial in anterior spine fusion. Both β-TCP and β-TCP+PRP had poorer radiological and histological outcomes than that of autograft after 3 months.
Literature
1.
Arm DM, Tencer AF, Bain SD, Celino D (1996) Effect of controlled release of platelet-derived growth factor from a porous hydroxyapatite implant on bone ingrowth. Biomaterials 17:703–709CrossRefPubMed
2.
Banwart JC, Asher MA, Hassanein RS (1995) Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine 20:1055–1060PubMed
3.
Boden SD, Martin GJ Jr, Morone MA, Ugbo JL, Moskovitz PA (1999) Posterolateral lumbar intertransverse process spine arthrodesis with recombinant human bone morphogenetic protein 2/hydroxyapatite-tricalcium phosphate after laminectomy in the nonhuman primate. Spine 24:1179–1185CrossRefPubMed
4.
Delecrin J, Aguado E, NGuyen JM, Pyre D, Royer J, Passuti N (1997) Influence of local environment on incorporation of ceramic for lumbar fusion. Comparison of laminar and intertransverse sites in a canine model. Spine 22:1683–1689CrossRefPubMed
5.
Emery SE, Fuller DA, Stevenson S (1996) Ceramic anterior spinal fusion. Biologic and biomechanical comparison in a canine model. Spine 21:2713–2719CrossRefPubMed
6.
Fernyhough JC, Schimandle JJ, Weigel MC, Edwards CC, Levine AM (1992) Chronic donor site pain complicating bone graft harvesting from the posterior iliac crest for spinal fusion. Spine 17:1474–1480PubMed
7.
Fuller DA, Stevenson S, Emery SE (1996) The effects of internal fixation on calcium carbonate. Ceramic anterior spinal fusion in dogs. Spine 21:2131–2136CrossRefPubMed
8.
Garcia-Bolao I, Merino J, Martinez A, Grau A, Alegria E, Martinez-Caro D (1996) Effect of hypercholesterolaemia on platelet growth factors. Eur J Clin Invest 26:929–935PubMed
9.
Grogaard B, Gerdin B, Reikeras O (1990) The polymorphonuclear leukocyte: has it a role in fracture healing? Arch Orthop Trauma Surg 109:268–271PubMed
10.
Gunzburg R, Szpalski M (2002) Use of a novel beta-tricalcium phosphate-based bone void filler as a graft extender in spinal fusion surgeries. Orthopedics 25(5 suppl):s591–s595PubMed
11.
Lee YM, Park YJ, Lee SJ, Ku Y, Han SB, Klokkevold PR, Chung CP (2000) The bone regenerative effect of platelet-derived growth factor-BB delivered with a chitosan/tricalcium phosphate sponge carrier. J Periodontol 71:418–424PubMed
12.
Li H, Zou X, Laursen M, Egund N, Lind M, Bünger C (2002) The influence of intervertebral disc tissue on anterior spinal interbody fusion: an experimental study on pigs. Eur Spine J 11:476–481CrossRefPubMed
13.
Lind M, Schumacker B, Soballe K, Keller J, Melsen F, Bunger C (1993) Transforming growth factor-beta enhances fracture healing in rabbit tibiae. Acta Orthop Scand 64:553–556PubMed
14.
Linovitz RJ, Peppers TA (2002) Use of an advanced formulation of beta-tricalcium phosphate as a bone extender in interbody lumbar fusion. Orthopedics 25(5 suppl):s585–s589PubMed
15.
Lowery GL, Kulkarni S, Pennisi AE (1999) Use of autologous growth factors in lumbar spinal fusion. Bone 25(2 suppl):47S–50SCrossRefPubMed
16.
Marden LJ, Fan RS, Pierce GF, Reddi AH, Hollinger JO (1993) Platelet-derived growth factor inhibits bone regeneration induced by osteogenin, a bone morphogenetic protein, in rat craniotomy defects. J Clin Invest 92:2897–2905PubMed
17.
Marie PJ, Hott M, Perheentupa J (1990) Effects of epidermal growth factor on bone formation and resorption in vivo. Am J Physiol 258:E275–E281PubMed
18.
Marx RE (2001) Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent 10:225–228PubMed
19.
Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR (1998) Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:638–646PubMed
20.
Ohyama T, Kubo Y, Iwata H, Taki W (2002) Beta-tricalcium phosphate as a substitute for autograft in interbody fusion cages in the canine lumbar spine. J Neurosurg 97(3 suppl):350–354PubMed
21.
Olutoye OO, Barone EJ, Yager DR, Cohen IK, Diegelmann RF (1997) Collagen induces cytokine release by fetal platelets: implications in scarless healing. J Pediatr Surg 32:827–830PubMed
22.
Siebrecht MA, De Rooij PP, Arm DM, Olsson ML, Aspenberg P (2002) Platelet concentrate increases bone ingrowth into porous hydroxyapatite. Orthopedics 25:169–172PubMed
23.
Slater M, Patava J, Kingham K, Mason RS (1995) Involvement of platelets in stimulating osteogenic activity. J Orthop Res 13:655–663PubMed
24.
Spencer EM, Liu CC, Si EC, Howard GA (1991) In vivo actions of insulin-like growth factor-I (IGF-I) on bone formation and resorption in rats. Bone 12:21–26PubMed
25.
Steffen T, Marchesi D, Aebi M (2000) Posterolateral and anterior interbody spinal fusion models in the sheep. Clin Orthop 371:28–37CrossRefPubMed
26.
Steffen T, Stoll T, Arvinte T, Schenk RK (2001) Porous tricalcium phosphate and transforming growth factor used for anterior spine surgery. Eur Spine J 10(suppl 2):S132–S140CrossRefPubMed
27.
Summers BN, Eisenstein SM (1989) Donor site pain from the ilium. A complication of lumbar spine fusion. J Bone Joint Surg Br 71:677–680PubMed
28.
Voggenreiter G, Assenmacher S, Kreuzfelder E, Wolf M, Kim MR, Nast-Kolb D, Schade FU (2000) Immunosuppression with FK506 increases bone induction in demineralized isogeneic and xenogeneic bone matrix in the rat. J Bone Miner Res 15:1825–1834PubMed
29.
Zou X, Xue Q, Li H, Bünger M, Lind M, Bünger C (2003) Effect of alendronate on bone ingrowth into porous tantalum and carbon fiber interbody devices: an experimental study in pigs. Acta Orthop Scand 74:596–603CrossRefPubMed
Metadata
Title
Anterior lumbar interbody fusion with carbon fiber cage loaded with bioceramics and platelet-rich plasma. An experimental study on pigs
Authors
Haisheng Li
Xuenong Zou
Qingyun Xue
Niels Egund
Martin Lind
Cody Bünger
Publication date
01-07-2004
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 4/2004
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-003-0647-3

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