584 - The Effect of Platelet Rich Fibrin Matrix and Bone Marrow Aspirate Enr...

#584 The Effect of Platelet Rich Fibrin Matrix and Bone Marrow Aspirate Enriched Scaffold on Posterolateral Lumbar Fusion in a Rabbit Model

Stem Cell Technologies

Poster Presented by: P.D. Kiely

Author(s):

P.D. Kiely (1)
A.T. Brecevich (1)
F.P. Cammisa (1)
C. Abjornson (1)

(1) Hospital for Special Surgery, Spine, New York, NY, United States

Abstract

Background: Alternatives to autogenous bone graft (ABG) are being explored, with platelet rich plasma products demonstrating exciting, but inconsistent osteoinductive potential [1].

Objective: Our objective was to evaluate the efficacy of PRFM in promoting spine fusion in the posterolateral lumbar spines of rabbits using a bone marrow aspirate (BMA) enriched β-TCP osteoconductive scaffold.

Methods: Thirty six (36) male New Zealand White (NZW) rabbits, weight range at the start of the study 3.5-4.0 kg, underwent bilateral posterolateral spine arthrodesis of the L5-L6 intertransverse processes, using either [saline soaked Vitoss β-TCP,

Group A, n=12], [Vitoss β-TCP + PRFM,

Group B, n=12], or [Vitoss(9) or Mosaik(3) β-TCP + PRFM + BMA,

Group C, n=12]. The animals were sacrificed 12 weeks post-operatively.

The lumbar spines were excised and mechanical stiffness was evaluated by manual palpation of the motion segment at the time of sacrifice. High-resolution radiographic images of the excised spines were scored according to the Lenke scale [3]. Micro-computed tomography (micro-CT) imaging was performed to determine quality and bone volume.

Results: None of the animals from Groups A and B demonstrated successful fusion by manual palpation, faxitron high resolution radiography nor micro CT scan. Only 3 animals in Group C demonstrated successful fusion, and all 3 animals belonged to the slower resorping [Mosaik β-TCP + PRFM + BMA] subgroup. Manual palpation, faxitron radiography and micro Ct all confirmed satisfactory fusion in this subgroup. The remaining 9 animals in Group C did not show fusion.

Conclusion: The effect of platelet rich fibrin matrix on bone marrow aspirate enriched scaffold in experimental posterolateral fusion appears to be dependent on the type of osteoconductive β-TCP.

References:

1. Boden S, Schimandle J, and Hutton WC. An Experimental Lumbar Intertransverse Process Spinal Fusion Model. Spine 1995; 20: 412-420.

2. Peerbooms JC et al. Positive Effect of an Autologous Platelet Concentrate in Lateral Epicondylitis. Am J Sports Med 2010; 38(2): 255-262.