title: Intrabody application of eptotermin alpha enhances bone formation in osteoporotic fractures of the lumbar spine; however, fails to increase biomechanical stability - results of an experimental sheep model.
abstract: This study analyses the effect of eptotermin α application into fractured vertebrae. It is hypothesized that eptotermin α is capable to enhance bony healing of the osteoporotic spine. In 10 Merino sheep osteoporosis induction was performed by ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet; followed by standardized creation of lumbar vertebral compression fractures (VCFs) type A3.1 and consecutive fracture reduction/fixation using expandable mesh cages. Randomly, intravertebral eptotermin α (G1) or no augmentation was added (G2). Macroscopic, micro-CT, and biomechanical evaluation assessed bony consolidation two months postoperatively: Micro-CT data revealed bony consolidation for all cases with significant increased callus development for G2 (60%) and BV/TV (bone volume/total volume 73.45%, osteoporotic vertebrae 35.76%). Neither group showed improved biomechanical stability. Eptotermin α enhanced mineralisation in VCFs in an experimental setup with use of cementless augmentation via an expandable cage. However, higher bone mineral density did not lead to superior biomechanical properties.
authors.affiliation: a Department of Trauma, Hand and Reconstructive Surgery , Rostock University, Medical Center , Rostock , Germany .
authors.forename: Anica
authors.initials: A
authors.lastname: Eschler
authors.affiliation: a Department of Trauma, Hand and Reconstructive Surgery , Rostock University, Medical Center , Rostock , Germany .
authors.forename: Paula
authors.initials: P
authors.lastname: Roepenack
authors.affiliation: a Department of Trauma, Hand and Reconstructive Surgery , Rostock University, Medical Center , Rostock , Germany .
authors.forename: Philipp Karl Ewald
authors.initials: PK
authors.lastname: Herlyn
authors.affiliation: b Clinic for Anesthesiology and Critical Care Medicine, Rostock University, Medical Center , Rostock , Germany .
authors.forename: Jan
authors.initials: J
authors.lastname: Roesner
authors.affiliation: c Institute for Biomedical Engineering, Rostock University, Medical Center , Rostock , Germany .
authors.forename: Heiner
authors.initials: H
authors.lastname: Martin
authors.affiliation: d Rudolf-Zenker-Institute for Experimental Surgery, Rostock University, Medical Center , Rostock , Germany , and.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Vollmar
authors.affiliation: a Department of Trauma, Hand and Reconstructive Surgery , Rostock University, Medical Center , Rostock , Germany .
authors.forename: Thomas
authors.initials: T
authors.lastname: Mittlmeier
authors.affiliation: e Department of Trauma, Orthopedic and Reconstructive Surgery , Munich Municipal Hospital Group, Clinic Harlaching , Munich , Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Gradl
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D015519:Bone Density; D055419:Bone Morphogenetic Protein 7 / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005592:Fracture Fixation / Q000379:methods; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000601:surgery*; D010012:Osteogenesis; D010024:Osteoporosis / Q000150:complications*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology; D012756:Sheep; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*
chemical_list: D055419:Bone Morphogenetic Protein 7; D011994:Recombinant Proteins
keywords: Eptotermin α; micro-CT; osteoporosis; rhBMP-7; sheep model; vertebral burst fracture