Evaluation of synthetic ceramics as compression resistant matrix to promote osteogenesis of autologous blood coagulum containing recombinant human bone morphogenetic protein 6 in rabbit posterolateral lumbar fusion model

Scientific paper - Original scientific paper

• Author: Nikola Štoković
• Author: Natalia Ivanjko
• Author: Marko Pećin
• Author: Igor Erjavec
• Author: Sven Karlović
• Author: Ana Smajlović
• Author: Hrvoje Capak
• Author: Milan Milošević
• Author: Jadranka Bubić Špoljar
• Author: Dražen Vnuk
• Author: Dražen Matičić
• Author: Hermann Oppermann
• Author: T. Kuber Sampath
• Author: Slobodan Vukičević
• Author's institution: University of Zagreb; School of Medicine; (Department of Anatomy and Clinical Anatomy)
• Author's institution: University of Zagreb; School of Medicine; (Department of Environmental and Occupational Health)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Anatomy
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Health Ecology

Abstract (english)

Posterolateral lumbar fusion (PLF) is a commonly performed surgical procedure for the treatment of pathological conditions of the lumbosacral spine. In the present study, we evaluated an autologous bone graft substitute (ABGS) containing rhBMP6 in autologous blood coagulum (ABC) and synthetic ceramics used as compression resistant matrix (CRM) in the rabbit PLF model. In the pilot PLF rabbit experiment, we tested four different CRMs (BCP 500-1700 μm, BCP 1700-2500 μm and two different TCP in the form of slabs) which were selected based on achieving uniform ABC distribution. Next, ABGS implants composed of 2.5 mL ABC with 0.5 g ceramic particles (TCP or BCP (TCP/HA 80/20) of particle size 500-1700 μm) and 125 μg rhBMP6 (added to blood or lyophilized on ceramics) were placed bilaterally between transverse processes of the lumbar vertebrae (L5-L6) following exposition and decortication in 12 New Zealand White Rabbits observed for 7 weeks following surgery. Spinal fusion outcome was analysed by μCT, palpatory segmental mobility testing and selected specimens were either tested biomechanically (three-point bending test) and/or processed histologically. The total fusion success rate was 90.9% by both μCT analyses and by palpatory segmental mobility testing. The volume of newly formed bone between experimental groups with TCP or BCP ceramics and the different method of rhBMP6 application was comparable. The newly formed bone and ceramic particles integrated with the transverse processes on histological sections resulting in superior biomechanical properties. The results were retrospectively found superior to allograft devitalized mineralized bone as a CRM as reported previously in rabbit PLF. Overall, this novel ABGS containing rhBMP6, ABC and the specific 500-1700 μm synthetic ceramic particles supported new bone formation for the first time and successfully promoted posterolateral lumbar fusion in rabbits.

• Keywords (english): Autologous blood coagulum; Autologous bone graft substitute (ABGS); BMP carrier; BMP6; Posterolateral lumbar fusion (PLF); Synthetic ceramics
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review - international
• Publication version: Published version
• Journal title: Bone
• Numbering: vol. 140, 115544
• p-ISSN: 8756-3282
• e-ISSN: 1873-2763
• DOI: https://doi.org/10.1016/j.bone.2020.115544
• URN:NBN: urn:nbn:hr:105:435020
• Publication: 2020-11
• Document URL: https://linkinghub.elsevier.com/retrieve/pii/S8756328220303240
• Type of resource: Text
• Access conditions: Open access
• Created on: 2021-04-29 09:11:46