Histological remodelling of demineralised bone matrix allograft in posterolateral fusion of the spine – an ex vivo study

BMC Surgery

Research Article

Samy Bouaicha¹  Guido A Wanner¹  Georg Osterhoff¹  Hans-Peter Simmen¹  Clément ML Werner¹  Brigitte von Rechenberg² 

[1] Division of Traumatology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland;Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland;

关键词: Spine fusion;    Demineralised bone matrix;    Histology;    Allograft;    Ex vivo;   

DOI  :  10.1186/1471-2482-13-58

 received in 2013-06-22, accepted in 2013-12-09,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundDemineralised bone matrix (DBM) has shown to be effective in enhancing posterior fusion of the spine. Several animal studies and clinical investigations in humans showed its successful remodelling. The use of allogenic matrix may decrease the need of autologous bone graft and therefore helps prevent corresponding donor site morbidity. Since DBM products are very expensive, the question arises, whether it is completely remodelled into new bone, and therefore truly is comparable to autologous cancellous bone graft. To our knowledge there is no report of a consecutive series of patients where ex vivo histological analysis after postero-lateral fusion of the spine was performed.MethodsOsseous biopsies of nine consecutive patients who underwent postero-lateral fusion of the spine for trauma were obtained at the time of elective removal of the hardware. Histological samples were then analyzed on ground and thin sections stained with toluidine blue and von Kossa stainings.ResultsTime span between index operation and removal of the metal ranged between 6 and 18 month. Histological analysis showed good incorporation and overall remodelling of DBM into new bone in all patients. No foreign body reaction was visible and new bone formation progressed time dependently with DBM in situ. Four out of nine patients showed more than 50% new bone formation after one year.ConclusionDBM shows good overall remodelling properties in histological analysis and therefore seems to be an effective adjunct in postero-lateral fusion of the spine. Furthermore, DBM substitution increases over time.

【 授权许可】

CC BY   
© Bouaicha et al.; licensee BioMed Central Ltd. 2013