Macroporous calcium phosphate ceramic performance in human spine fusion

Area of Science:

• Biomaterials Science
• Orthopedic Surgery
• Spinal Fusion

Background:

• Macroporous biphasic calcium phosphate (MBCP) has shown promise in experimental canine spine fusion studies.
• Bone graft substitutes are crucial for spinal fusion, especially when autograft availability is limited.

Purpose of the Study:

• To evaluate the efficacy of MBCP as a bone graft substitute in adolescent patients undergoing spinal fusion for scoliosis.
• To assess the clinical, radiographic, and histological outcomes of MBCP in challenging spinal fusion cases.

Main Methods:

• MBCP blocks were used in 12 adolescent patients (11-18 years) with severe scoliosis requiring spinal fusion.
• Patients had limited autograft availability due to conditions like severe neurologic scoliosis and osteogenesis imperfecta.
• Treatment involved MBCP combined with Cotrel-Dubousset instrumentation, with follow-up up to 24 months, including biopsies in two cases.

Main Results:

• Histologic, ultrastructural, and microanalysis confirmed MBCP's effectiveness as a bone graft substitute for spine fusion.
• Clinical and biological assessments were normal, indicating good patient outcomes.
• Histological evaluation demonstrated MBCP's bioactivity and osteoconductive properties, with partial resorption and lamellar bone formation.

Conclusions:

• MBCP is an effective bone graft substitute for spinal fusion in adolescent scoliosis patients, particularly when autograft is insufficient.
• The combination of MBCP with strong spinal instrumentation facilitates successful bone fusion.
• MBCP exhibits bioactivity and osteoconduction, leading to lamellar bone formation and partial material resorption.