Cervical interbody fusion is enhanced by allogeneic mesenchymal precursor cells in an ovine model

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STUDY DESIGN: An experimental study using a sheep cervical spine interbody fusion model. OBJECTIVES: To compare allogeneic mesenchymal precursor cells combined with hydroxyapatite and tricalcium phosphate (HA/TCP) with HA/TCP alone or iliac crest autograft (AG) for cervical interbody fusion. SUMMARY OF BACKGROUND DATA: We investigated the effect of mesenchymal precursor cells on cervical fusion because of the shortcomings of using iliac crest (donor site morbidity), bone substitute (poor osteoinductive properties) and bone morphogenic proteins (serious complications). METHODS: Thirty ewes were divided randomly into four groups of six having C3/4 anterior cervical discectomy and fusion using a FidjiTM cage packed with, AG, HA/TCP, HA/TCP containing 5 million MPCs, and HA/TCP containing 10 million MPCs. MPCs were derived from a single batch of immuno-selected and culture-expanded MPCs isolated from bone marrow of out-bred sheep. The fifth group were non-operated controls. Safety, fusion parameters and biomechanics were assessed. RESULTS: No cell related adverse events were observed. No significant differences were found between the 5 or 10 million MPC groups. Evaluation of fusion by CT scan at 3 months showed that 9/12 (75 ) MPC-treated animals had continuous bony bridging compared with only 1/6 AG and 2/6 HA/TCP (p = 0.019 and p = 0.044 respectively). By quantitative CT, density of new bone in MPC-treated animals was 121 higher than in HA/TCP (p = 0.017) and 128 higher than in AG (p <0.0001). Functional radiology at 3 months revealed that MPC-treated animals had significantly reduced macro-motion at C3/4 compared with AG and HA/TCP groups combined...
Original languageEnglish
Pages (from-to)615 - 623
Number of pages9
Issue number8
Publication statusPublished - 2011

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