title: Application of a three-dimensional graft of autologous osteodifferentiated adipose stem cells in patients undergoing minimally invasive transforaminal lumbar interbody fusion: clinical proof of concept.
abstract: The authors applied a scaffold-free osteogenic three-dimensional (3D) graft made of adipose-derived mesenchymal stem cells (AMSCs) in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).
  
  
  
  Three patients (two patients and one patient with 1 and 2 levels, respectively) with degenerative spondylolisthesis underwent MI-TLIF with 3D graft made of AMSCs. To obtain the AMSCs, fatty tissue was collected from the abdomen by lipoaspiration and differentiated afterwards in our Cell/Tissue bank. Clinical outcomes, including the Oswestry Disability Index (ODI) and visual analog scale (VAS) as well as fusion status were assessed preoperatively and up to 12 months postoperatively.
  
  
  
  At 12 months, all four operated AMSC levels could be assessed (n = 4). Grade 3 fusion could be confirmed at two levels out of four. Mean VAS score improved from 8.3 to 2 and ODI also improved from 47 to 31%. No donor site complication was observed. The final AMSC osteogenic product was stable, did not rupture with forceps manipulation, and was easily implanted directly into the cage with no marked modification of operating time.
  
  
  
  A scaffold-free 3D graft made of AMSCs can be manufactured and used as a promising alternative for spinal fusion procedures. Nevertheless, further studies of a larger series of patients are needed to confirm its effectiveness.
authors.affiliation: Department of Neurosurgery, University Hospital Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200, Brussels, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Fomekong
authors.affiliation: Endocrine Cell Therapy Unit, Center of Tissue and Cell Therapy, university hospital Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200, Brussels, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Dufrane
authors.affiliation: Department of Radiology, University Hospital Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200, Brussels, Belgium.
authors.forename: B Vande
authors.initials: BV
authors.lastname: Berg
authors.affiliation: Endocrine Cell Therapy Unit, Center of Tissue and Cell Therapy, university hospital Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200, Brussels, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: André
authors.affiliation: Endocrine Cell Therapy Unit, Center of Tissue and Cell Therapy, university hospital Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200, Brussels, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Aouassar
authors.affiliation: Endocrine Cell Therapy Unit, Center of Tissue and Cell Therapy, university hospital Saint-Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200, Brussels, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Veriter
authors.affiliation: Department of Neurosurgery, University Hospital Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200, Brussels, Belgium. christian.raftopoulos@uclouvain.be.
authors.forename: C
authors.initials: C
authors.lastname: Raftopoulos
mesh_terms: D017667:Adipocytes / Q000166:cytology; D000328:Adult; D000368:Aged; D002454:Cell Differentiation; D005260:Female; D006801:Humans; 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*; D010011:Osteocytes / Q000166:cytology / Q000637:transplantation; D011183:Postoperative Complications / Q000453:epidemiology; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013168:Spondylolisthesis / Q000601:surgery*
keywords: Adipose-derived mesenchymal stem cells; Bone graft; Fusion rate; Spondylolisthesis; Transforaminal lumbar interbody fusion