Osteogenesis induced by autologous bone marrow cells transplant in the pediatric skull.
OBJECTIVE
The ability of cranial bone to repair defects of continuity is limited and it is mostly dependent on the age of the patient. In infancy and in early pediatric age, the scarce thickness of the calvarial bones and the need for a harmonic development of the child's skull limit the application of most of the surgical procedures usually utilized in older patients. We tested the ability of mononucleated cells, derived from the patient's bone marrow and transplanted on the site of the cranial bone defect, to increase the rate of mineralization of the autologous osteogenesis to obtain the complete restoration of the skull continuity.


METHODS
Four children, aged 26, 28, 37, and 79 months, respectively, affected by a stabilized and persistent cranial bone defect of posttraumatic or postsurgical origin, were treated. A sandwich-shaped shell, made of extrused absorbable polylactic copolymers material, was used to hold in place a freeze-dried mineralized collagen matrix associated with a nonceramic hydroxyapatite scaffold, where autologous bone marrow mononucleated cells were inseminated.


RESULTS
In all patients, a rapid autologous bone osteogenesis was observed with a clear dimensional reduction of the bone defect few months after the autologous bone marrow cells seeding.


CONCLUSIONS
The preliminary results of this research suggest the use of autologous bone marrow cells to increase the autologous osteogenesis in early pediatric age in cases in which correction of skull bone defects is best realized with autologous bone.
Velardi
Francesco
F
Neurotraumatology, Pediatric Hospital "Bambino Gesù", Piazza S. Onofrio 5, Rome 00165, Italy. fvelardi@opbg.net
Amante
Paolina R
PR
Caniglia
Maurizio
M
De Rossi
Giulio
G
Gaglini
Pierpaolo
P
Isacchi
Giancarlo
G
Palma
Paolo
P
Procaccini
Emidio
E
Zinno
Francesco
F
D000367:Age Factors; D015519:Bone Density / Q000502:physiology*; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003094:Collagen; D003399:Craniotomy; D017886:Durapatite; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D019344:Lactic Acid; D008297:Male; D010012:Osteogenesis / Q000502:physiology*; D011091:Polyesters; D011108:Polymers; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019736:Prostheses and Implants; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery*; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D023822:Tissue Engineering; D014057:Tomography, X-Ray Computed
D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide); D003094:Collagen; D017886:Durapatite