Endoscopic Instrumented Posterolateral Lumbar Fusion with Healos and Recombinant Human Growth/Differentiation Factor-5

Tae Ahn Jahng, Tsai Sheng Fu, Bryan W. Cunningham, Anton E. Dmitriev, Daniel H. Kim, Volker K H Sonntag, Edward C. Benzel, John E. O'Toole, Paul C. McCormick, Michael Y. Wang, Richard G. Fessler

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

OBJECTIVE: The goal of this study was to use a minimally invasive endoscopic surgical technique in a sheep model to evaluate the efficacy of an osteoinductive growth factor, recombinant human growth/differentiation factor-5 (also designated MP52), and an osteoconductive matrix formulation (Healos; DePuy AcroMed, Inc., Mountain View, CA) for inducing and facilitating bone formation. METHODS: Twelve mature sheep underwent bilateral posterolateral lumbar fusion and pedicle screw fixation via a posterior endoscopic approach. Each sheep received two different types of graft material, autogenous iliac crest bone, or a bone graft substitute (MP52 with Healos), inserted into the right and left sides of the spine in an alternating fashion. Groups of four sheep were killed at 2, 4, and 6 months postoperatively for manual, radiographic, and histological evaluation. RESULTS: No neurological impairments, infections, or other complications were observed. After 2 months, partial fusion on both sides was observed, but radiographic evaluation showed greater bone growth on the side that received the bone graft substitute. Solid posterolateral fusion was observed in both autograft and bone graft substitute sites at 4 and 6 months, and autograft and Healos MP52 fusion sites were essentially the same at histological examination. There was no abnormal overgrowth of new bone from either of these two materials. CONCLUSION: Endoscopic posterolateral lumbar arthrodesis and instrumentation is feasible, safe, and effective in a sheep model. Healos is a useful bonding agent that mimics natural bone in posterolateral intertransverse fusion sites. Combined with MP52, it produced fusion comparable to that of autogenous bone graft. Minimally invasive techniques and bone graft substitutes could eliminate morbidity and increase the likelihood of successful fusion.

Original languageEnglish
Pages (from-to)171-181
Number of pages11
JournalNeurosurgery
Volume54
Issue number1
StatePublished - Jan 1 2004
Externally publishedYes

Fingerprint

Bone Substitutes
Sheep
Transplants
Bone and Bones
Autografts
Arthrodesis
Bone Development
Osteogenesis
Healos
human GDF5 protein
Intercellular Signaling Peptides and Proteins
Spine
Morbidity
Infection

Keywords

  • Endoscopy
  • Healos
  • Posterolateral lumbar fusion
  • Recombinant human growth/differentiation factor-5

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Jahng, T. A., Fu, T. S., Cunningham, B. W., Dmitriev, A. E., Kim, D. H., Sonntag, V. K. H., ... Fessler, R. G. (2004). Endoscopic Instrumented Posterolateral Lumbar Fusion with Healos and Recombinant Human Growth/Differentiation Factor-5. Neurosurgery, 54(1), 171-181.

Endoscopic Instrumented Posterolateral Lumbar Fusion with Healos and Recombinant Human Growth/Differentiation Factor-5. / Jahng, Tae Ahn; Fu, Tsai Sheng; Cunningham, Bryan W.; Dmitriev, Anton E.; Kim, Daniel H.; Sonntag, Volker K H; Benzel, Edward C.; O'Toole, John E.; McCormick, Paul C.; Wang, Michael Y.; Fessler, Richard G.

In: Neurosurgery, Vol. 54, No. 1, 01.01.2004, p. 171-181.

Research output: Contribution to journalArticle

Jahng, TA, Fu, TS, Cunningham, BW, Dmitriev, AE, Kim, DH, Sonntag, VKH, Benzel, EC, O'Toole, JE, McCormick, PC, Wang, MY & Fessler, RG 2004, 'Endoscopic Instrumented Posterolateral Lumbar Fusion with Healos and Recombinant Human Growth/Differentiation Factor-5', Neurosurgery, vol. 54, no. 1, pp. 171-181.
Jahng TA, Fu TS, Cunningham BW, Dmitriev AE, Kim DH, Sonntag VKH et al. Endoscopic Instrumented Posterolateral Lumbar Fusion with Healos and Recombinant Human Growth/Differentiation Factor-5. Neurosurgery. 2004 Jan 1;54(1):171-181.
Jahng, Tae Ahn ; Fu, Tsai Sheng ; Cunningham, Bryan W. ; Dmitriev, Anton E. ; Kim, Daniel H. ; Sonntag, Volker K H ; Benzel, Edward C. ; O'Toole, John E. ; McCormick, Paul C. ; Wang, Michael Y. ; Fessler, Richard G. / Endoscopic Instrumented Posterolateral Lumbar Fusion with Healos and Recombinant Human Growth/Differentiation Factor-5. In: Neurosurgery. 2004 ; Vol. 54, No. 1. pp. 171-181.
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