Enhancement of posterolateral lumbar spine fusion using low-dose rhBMP-2 and cultured marrow stromal cells.
We tested the hypothesis that the dose of recombinant human bone morphogenetic protein-2 (rhBMP-2) required to induce spine fusion can be reduced by combination with mesenchymal stem cells (MSCs). Twenty-four adult rabbits underwent posterolateral intertransverse fusion at the L4-L5 level. The animals were divided into four groups based on the implant material: autologous iliac graft, Alginate-MSCs composite, Alginate-BMP-2-MSCs composite, and Alginate-BMP-2 composite. After 16 weeks, the rabbits were euthanized for radiographic examination, manual palpation, biomechanical testing, and histology. Radiographic union of 12 intertransverse fusion areas for the autogenous iliac graft, Alginate-MSCs, Alginate-BMP-2-MSCs, and Alginate-BMP-2 groups was 11, 8, 11, and 0, respectively. Moreover, manual palpation of six fusion segments in each subgroup found solid union to be 6, 1, 5, and 0, respectively. The average torques at failure of the first three groups were 2278 +/- 135, 1943 +/- 140, and 2334 +/- 187 N-mm, respectively. The failure torque did not differ significantly between the autograft and Alginate-BMP-2-MSCs groups; both groups were significantly higher than the Alginate-MSCs group. The results indicate that MSCs delivered with in vitro cellular doses of rhBMP-2 are more osteoinductive than MSCs without rhBMP-2. In combination with MSCs, a low dose (2.5 microg) of rh-BMP-2 could enhance bone formation and posterolateral spine fusion success in the rabbit model.
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Hsing Street, 333, Kweishan, Taoyuan, Taiwan.
Tsai-Sheng
TS
Fu
Wen-Jer
WJ
Chen
Lih-Huei
LH
Chen
Song-Shu
SS
Lin
Shih-Jung
SJ
Liu
Steve W N
SW
Ueng
D000818:Animals; D055396:Bone Morphogenetic Protein 2 / Q000494:pharmacology / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000187:drug effects; D002478:Cells, Cultured; D006801:Humans; D008159:Lumbar Vertebrae / Q000166:cytology / Q000000981:diagnostic imaging / Q000187:drug effects; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells / Q000166:cytology / Q000187:drug effects*; D010012:Osteogenesis / Q000187:drug effects*; D011817:Rabbits; D011859:Radiography; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use; D013123:Spinal Fusion; D054159:Torsion, Mechanical
C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D011994:Recombinant Proteins