title: The role of Osteocel Plus as a fusion substrate in minimally invasive instrumented transforaminal lumbar interbody fusion.
abstract: BACKGROUND
  Instrumented lumbar fusion has become an accepted and effective surgical technique used to address a wide variety of conditions of the lumbar spine. Iliac crest autograft remains the gold standard with regards to bony fusion substrate. Unfortunately there are significant potential disadvantages associated with autograft harvest, including pain, infection, iatrogenic fracture and bleeding. Osteocel Plus (OC+) is an allograft cellular bone matrix containing mesenchymal stem cells (MSCs) and osteoprogenitor cells combined with DBM and cancellous bone. OC+ is designed to mimic the osteobiologic profile of human autograft bone, thereby eliminating the risks of autograft harvest.
  
  
  METHODS
  A retrospective chart review was conducted to identify all patients who had undergone a MITLIF with OC+ for degenerative lumbar conditions. Patient demographics including age, sex, history of risk factors for nonunion including: osteoporosis documented on DEXA scanning, diabetes mellitus, smoking or steroid use were examined and recorded. Successful arthrodesis was judged based on post-operative X-ray imaging.
  
  
  RESULTS
  23 patients at 26 spinal levels underwent a MITLIF with OC+. Twenty-one patients (91.3%) and 24 levels (92.3%) went on to achieve radiographic evidence of solid bony arthrodesis by 12 months post-op. Six patients (26%) demonstrated clear evidence of early interbody bone growth within 6 months of surgery.
  
  
  CONCLUSIONS
  OC+ results in robust and reproducible lumbar interbody fusion, in both young and older patients.
authors.affiliation: Department of Neurological Surgery, George Washington University School of Medicine, Washington, DC, USA. jmawna@gmail.com
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Ammerman
authors.forename: Joseph
authors.initials: J
authors.lastname: Libricz
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Ammerman
mesh_terms: D000368:Aged; D001174:Arthrodesis; D001857:Bone Matrix; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D011859:Radiography; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013234:Stem Cells; D016896:Treatment Outcome