Faculty Collaboration Database

Instrumented Lumbar Corpectomy and Spinal Reconstruction Comparing rhBMP-2/Compression-Resistant Matrix, rhBMP-2/Absorbable Collagen Sponge/Ceramic Granules Mixture, and Autograft in Two Different Devices: A Study in Sheep. Spine (Phila Pa 1976) 2016 Mar;41(6):E313-22

Date

11/05/2015

Pubmed ID

26536446

DOI

10.1097/BRS.0000000000001256

Scopus ID

2-s2.0-84946423455 (requires institutional sign-in at Scopus site)

Abstract

STUDY DESIGN: Fusion success with rhBMP-2 and autograft in titanium or PEEK corpectomy devices was evaluated in a sheep lumbar corpectomy model. The 6 treatment groups included titanium mesh or PEEK corpectomy devices filled with rhBMP-2 on a compression-resistant matrix (CRM) carrier; rhBMP-2 in a morselized absorbable collagen sponge (ACS) carrier combined with resorbable ceramic granules; and autograft.

OBJECTIVE: The aim of this study was to determine fusion rates associated with 2 different preparations of rhBMP-2 as well as autograft in an instrumented ovine lumbar corpectomy model 6 months postoperatively.

SUMMARY OF BACKGROUND DATA: Vertebral reconstruction with corpectomy devices requires bone graft. Bone graft substitutes have the potential to avoid a second operation, donor site pain, and attendant morbidity associated with autograft.

METHODS: Twenty-four sheep in 6 treatment groups underwent lumbar corpectomy via a retroperitoneal trans-psoas approach. Spines were reconstructed with autograft, rhBMP-2 on a CRM, or rhBMP-2 on an ACS mixed with ceramic granules. Grafting materials were placed in either a titanium mesh or PEEK conduit in spines with internal fixation. Computed tomographic (CT) scans were evaluated for fusion. Undecalcified histology was used to evaluate for fusion as well as the amount and extent of graft incorporation and graft resorption.

RESULTS: Regardless of corpectomy device used, rhBMP-2/CRM or rhBMP-2/ACS with MASTERGRAFT resulted in a 100% fusion rate. The autograft group had a lower (75%) radiographic fusion rate. Using either preparation of rhBMP-2 resulted in the length of the defect filling with solid bone. Autograft fragments and ceramic granules were incorporated into the fusion masses with much of the ceramic granules being resorbed by 6 months.

CONCLUSION: Both of the rhBMP-2 formulations have the potential to effect bony fusion and vertebral reconstruction within the corpectomy devices.

Author List

Toth JM, Schwartz DG, Mobasser JP, Williams J

Author

Jeffrey M. Toth PhD Associate Dean for Research in the School of Dentistry department at Marquette University

MESH terms used to index this publication - Major topics in bold

Animals
Autografts
Benzophenones
Bone Morphogenetic Protein 2
Ceramics
Collagen
Female
Ketones
Polyethylene Glycols
Polymers
Prosthesis Design
Recombinant Proteins
Sheep
Spinal Fusion
Spine
Transforming Growth Factor beta