115 - Cervical Interbody Fusion Rates with i-FACTOR™ Peptide Enhanced Bone G...

#115 Cervical Interbody Fusion Rates with i-FACTOR™ Peptide Enhanced Bone Graft

Biologic Therapies

Poster Presented by: A.J. Berg

Author(s):

A.J. Berg (1)
J.A. Tankel (1)
C.D. Jensen (1)
M. Hernandez (1)
C. Bhatia (1)
G.R. Reddy (1)
T. Friesem (1)

(1) North Tees and Hartlepool NHS Foundation Trust, Spinal Unit, Stockton on Tees, United Kingdom

Abstract

Introduction and Purpose: The gold standard bone graft for augmenting cervical fusion is iliac crest autograft. Significant donor morbidity is associated with its harvest. Allografts require processing, to prevent transmission of infections, which impairs their osteogenic and osteoinductive properties. An alternative synthetic bone graft is therefore desired. We report fusion rates in cervical fusion procedures with a combination of morzelised local autograft and i-FACTOR™, a synthetic bone graft consisting of synthetic small peptide osteogenic precursor cell attachment factors (P-15™) bound to anorganic bone mineral. i-FACTOR™ is reported to provide safe predictable bone formation. To our knowledge there is no independent data published on the use of this product in cervical fusions.

Methods: Retrospective analysis of all cervical fusion procedures with i-FACTOR™ over an 18 month period was performed. An independent blinded radiologist reviewed postoperative radiographs. Operated levels were classified as “not fused”, “progressing fusion” or “fused”, based on the presences of spanning trabeculae on orthogonal radiographs.

Results: Thirty levels in 17 patients were analyzed. 24 levels (80%) were classified as “fused” at mean 26 (range 13 - 65) weeks. Five levels (four patients) were classified as “progressing fusion” at mean 17 (range 12-19) weeks. One patient/level had “not fused” at their last radiographic assessment, 18 weeks post-operatively. No adverse events associated with the bone graft were reported.

Conclusions: The use of i-FACTOR™ combined with morselized local autograft provided reliable cervical fusion. 80% of levels had fused by mean 26 weeks post-operatively while 17% showed “progressing fusion” by mean 17 weeks post-operatively.