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A comparison of commercially available demineralized bone matrices with and without human mesenchymal stem cells in a rodent spinal fusion model

Tetsuo Hayashi Department of Orthopaedic Surgery, University of California, Los Angeles, California;
Department of Orthopaedic Surgery, Japan Labour Health and Welfare Organization, Spinal Injuries Center, Fukuoka, Japan;

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Elizabeth L. Lord Department of Orthopaedic Surgery, University of California, Los Angeles, California;

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Akinobu Suzuki Department of Orthopaedic Surgery, University of California, Los Angeles, California;

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Shinji Takahashi Department of Orthopaedic Surgery, University of California, Los Angeles, California;

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Trevor P. Scott Department of Orthopaedic Surgery, University of California, Los Angeles, California;

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Kevin Phan Department of Orthopaedic Surgery, University of California, Los Angeles, California;

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Haijun Tian Department of Orthopaedic Surgery, University of California, Los Angeles, California;

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Michael D. Daubs Department of Orthopaedic Surgery, University of Nevada, Las Vegas, Nevada; and

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Keiichiro Shiba Department of Orthopaedic Surgery, Japan Labour Health and Welfare Organization, Spinal Injuries Center, Fukuoka, Japan;

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Jeffrey C. Wang Department of Orthopaedic Surgery, University of Southern California, Los Angeles, California

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Page Range:
133–137
Volume/Issue:
Volume 25: Issue 1
DOI link:
https://doi.org/10.3171/2015.12.SPINE15737
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OBJECTIVE

The efficacy of some demineralized bone matrix (DBM) substances has been demonstrated in the spinal fusion of rats; however, no previous comparative study has reported the efficacy of DBM with human mesenchymal stem cells (hMSCs). There is an added cost to the products with stem cells, which should be justified by improved osteogenic potential. The purpose of this study is to prospectively compare the fusion rates of 3 different commercially available DBM substances, both with and without hMSCs.

METHODS

Posterolateral fusion was performed in 32 mature athymic nude rats. Three groups of 8 rats were implanted with 1 of 3 DBMs: Trinity Evolution (DBM with stem cells), Grafton (DBM without stem cells), or DBX (DBM without stem cells). A fourth group with no implanted material was used as a control group. Radiographs were obtained at 2, 4, and 8 weeks. The rats were euthanized at 8 weeks. Overall fusion was determined by manual palpation and micro-CT.

RESULTS

The fusion rates at 8 weeks on the radiographs for Trinity Evolution, Grafton, and DBX were 8 of 8 rats, 3 of 8 rats, and 5 of 8 rats, respectively. A significant difference was found between Trinity Evolution and Grafton (p = 0.01). The overall fusion rates as determined by micro-CT and manual palpation for Trinity Evolution, Grafton, and DBX were 4 of 8 rats, 3 of 8 rats, and 3 of 8 rats, respectively. The Trinity Evolution substance had the highest overall fusion rate, however no significant difference was found between groups.

CONCLUSIONS

The efficacies of these DBM substances are demonstrated; however, the advantage of DBM with hMSCs could not be found in terms of posterolateral fusion. When evaluating spinal fusion using DBM substances, CT analysis is necessary in order to not overestimate fusion.

ABBREVIATIONS

DBM = demineralized bone matrix; hMSC = human mesenchymal stem cell.
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Volume 25: Issue 1

Contributor Notes

INCLUDE WHEN CITING Published online March 11, 2016; DOI: 10.3171/2015.12.SPINE15737.

Correspondence Tetsuo Hayashi, Department of Orthopaedic Surgery, Japan Labour Health and Welfare Organization, Spinal Injuries Center, 550-4 Igisu, Iizuka city, Fukuoka 820-8508, Japan. email: tetsuo884hayashi@yahoo.co.jp.
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