Abstract
BackgroundDespite widespread use of femoral-sourced allografts in clinical spinal fusion procedures and the increasing interest in using femoral reamer–irrigator–aspirator (RIA) autograft in clinical bone grafting, few studies have examined the efficacy of femoral grafts compared to iliac crest grafts in spinal fusion. The objective of this study was to directly compare the use of autologous iliac crest with syngeneic femoral and iliac allograft bone in the rat model of lumbar spinal fusion.MethodsSingle-level bilateral posterolateral intertransverse process lumbar spinal fusion surgery was performed on Lewis rats divided into three experimental groups: iliac crest autograft, syngeneic iliac crest allograft, and syngeneic femoral allograft bone. Eight weeks postoperatively, fusion was evaluated via microCT analysis, manual palpation, and histology. In vitro analysis of the colony-forming and osteogenic capacity of bone marrow cells derived from rat femurs and hips was also performed to determine whether there was a correlation with the fusion efficacy of these graft sources.ResultsAlthough no differences were observed between groups in CT fusion mass volumes, iliac allografts displayed an increased number of radiographically fused fusion masses and a higher rate of bilateral fusion via manual palpation. Histologically, hip-derived grafts showed better integration with host bone than femur derived ones, likely associated with the higher concentration of osteogenic progenitor cells observed in hip-derived bone marrow.ConclusionsThis study demonstrates the feasibility of using syngeneic allograft bone in place of autograft bone within inbred rat fusion models and highlights the need for further study of femoral-derived grafts in fusion.
Highlights
Despite widespread use of femoral-sourced allografts in clinical spinal fusion procedures and the increasing interest in using femoral reamer–irrigator–aspirator (RIA) autograft in clinical bone grafting, few studies have examined the efficacy of femoral grafts compared to iliac crest grafts in spinal fusion
There was no significant difference among the mean pre-implantation graft weights which were 0.151 ± 0.092 g, 0.175 ± 0.064 g, and 0.209 ± 0.048 g for grafts derived from autograft hip, allograft hip, and allograft femur, respectively (p = 0.113, Fig. 1a)
Another probable contributing factor is the slight difference in overall graft compositions, as the syngeneic hip allografts were derived from the whole ilium, while the autografts consisted of the iliac crest alone, leading to possible differences in cortical-to-trabecular ratios as well as total cellular composition and concentration
Summary
Despite widespread use of femoral-sourced allografts in clinical spinal fusion procedures and the increasing interest in using femoral reamer–irrigator–aspirator (RIA) autograft in clinical bone grafting, few studies have examined the efficacy of femoral grafts compared to iliac crest grafts in spinal fusion. The objective of this study was to directly compare the use of autologous iliac crest with syngeneic femoral and iliac allograft bone in the rat model of lumbar spinal fusion. The rat posterolateral spinal fusion model has become an increasingly popular experimental model to assess the efficacy of novel fusion treatments [2]. Compared to other commonly used animal models in spinal fusion research, such as rabbits, sheep, goats, pigs, dogs, and monkeys, the rat model presents a number of key advantages [3]. Various fusion therapies have been studied in rat models, including a range of bone graft substitute and extension materials, systemic and localized delivery of osteogenic growth factors and/or osteoporosis therapies, and stem cell transplantation therapies [4,5,6,7,8,9,10,11,12,13,14]
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