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In vitro osteoblast proliferation as a predictor for spinal fusion mass
Thomas Andersen1, Finn Bjarke Christensen, Malene Laursen
1Orthopaedic Research Laboratory, Aarhus University Hospital, Aarhus, Denmark. tba@dadlnet.dk
Background Context:
The biological factors determining a successful spinal fusion have not yet been fully determined.
Purpose:
To determine the influence of graft cell vigor on fusion rate and fusion mass using in vitro osteoblast proliferation as a predictor.
Study Design:
Animal study randomizing to posterolateral fusion with autograft with or without pedicle-screw instrumentation.
Patient Sample:
Twenty adult Göttingen mini-pigs.
Outcome Measures:
Fusion rate measured both with X-ray and computed tomography (CT) as well as amount of fusion mass determined with three-dimensional CT.
Methods:
Animals underwent posterolateral fusion with autograft either with or without pedicle-screw instrumentation. Additional graft was harvested for osteoblastlike cell culture. Cells were counted after 3 weeks, and their proliferative capacity was correlated to fusion rate and fusion amount.
Results:
Cell count was significantly higher in the fused animals (p<.011). Furthermore, a tendency toward a positive correlation to fusion mass amount was observed (p<.091).
Conclusions:
The achievement of a solid spinal fusion using autograft is related to properties of the bone-forming cells in the graft and fusion bed. Most likely it is the number of cells and not their proliferative capacity that is the most important factor.
