title: Enhanced spinal fusion using a biodegradable porous mesh container in a rat posterolateral spinal fusion model.
abstract: BACKGROUND
  Posterolateral fusion (PLF) with an autogenous iliac bone graft is the most common procedure for treating various lumbar spinal diseases. However, the limited success and associated morbidity from an iliac crest graft demands new biologically competent graft enhancers or substitutes.
  
  
  OBJECTIVE
  To investigate the feasibility of tubular mesh container made of bioabsorbable sutures (poly-1,4-dioxane-2-one, PDO) for spinal fusion.
  
  
  METHODS
  Experimental animal study.
  
  
  METHODS
  A biodegradable PDO tubular mesh container was used to contain small pieces of bone grafts. Twenty Sprague-Dawley male rats underwent PLF between L4 and L5 transverse processes with bilateral iliac grafts. Experimental animals were assigned into two different groups: autograft-only group (N=10) that underwent PLF with autograft-only or mesh container group (N=10) that underwent PLF with tubular mesh container filled with autogenous bone grafts. The rats were sacrificed at 8 weeks postoperatively, and the lumbar spines were removed. Spinal fusion was evaluated by manual palpation, microcomputed tomography, three-point bending test, and histological examination.
  
  
  RESULTS
  Solid fusion was achieved in all cases of the mesh container group, whereas the autograft-only group showed 60% of solid fusion. New bone mass was higher and more solidly fused in the mesh container group than the autograft-only group (p<.01). Volume of fusion mass and density of bone were significantly higher in the mesh container group (p<.05). In all cases, inflammatory response was minimal.
  
  
  CONCLUSIONS
  This study demonstrated that a tubular mesh container made of bioabsorbable suture is useful to hold small pieces of bone grafts and to enhance spinal fusion.
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 120-752, Republic of Korea.
authors.forename: Dong-Ah
authors.initials: DA
authors.lastname: Shin
authors.affiliation: School of Materials Science and Engineering, Gwangju Institute of Science and Technology, 123 Cheomdan-gwagiro, Buk-gu, Gwangju, 500-712, Republic of Korea.
authors.forename: Bo Mi
authors.initials: BM
authors.lastname: Yang
authors.affiliation: School of Materials Science and Engineering, Gwangju Institute of Science and Technology, 123 Cheomdan-gwagiro, Buk-gu, Gwangju, 500-712, Republic of Korea.
authors.forename: Giyoong
authors.initials: G
authors.lastname: Tae
authors.affiliation: Department of Chemistry, Chung-Ang University, 84 Heukseok-Ro, Dongjak-Gu, Seoul, Republic of Korea.
authors.forename: Young Ha
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Forensic Medicine, Chonnam National University Medical School, 42 Jebong-Ro, Dong-Gu, Gwangju, 501-757, Republic of Korea.
authors.forename: Hyung-Seok
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Medical System Engineering, Gwangju Institute of Science and Technology, 123 Cheomdan-gwagiro, Buk-gu, Gwangju, 500-712, Republic of Korea; Department of Neurosurgery, Presbyterian Medical Center, 1-300 Junghwasan-dong, Wansangu, Jeonju, Jeonbuk, Republic of Korea. Electronic address: Hyoungihl@gist.ac.kr.
authors.forename: Hyoung-Ihl
authors.initials: HI
authors.lastname: Kim
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D001696:Biomechanical Phenomena / Q000502:physiology; D016025:Bone Transplantation / Q000379:methods; D005240:Feasibility Studies; D007085:Ilium / Q000601:surgery; D008297:Male; D023421:Models, Animal; D010012:Osteogenesis / Q000502:physiology; D051381:Rats; D017207:Rats, Sprague-Dawley; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D013131:Spine / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery*; D055114:X-Ray Microtomography
keywords: Animal model; Biodegration; Bone graft; Polydioxanone; Pseudoathrosis; Spinal fusion