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Type: Journal article
Title: A Comparison of mesenchymal precursor cells and amnion epithelial cells for enhancing cervical interbody fusion in an ovine model
Author: Goldschlager, T.
Ghosh, P.
Zannettino, A.
Williamson, M.
Rosenfeld, J.
Itescu, S.
Jenkin, G.
Citation: Neurosurgery, 2011; 68(4):1025-1034
Publisher: Lippincott Williams & Wilkins
Issue Date: 2011
ISSN: 0148-396X
Statement of
Tony Goldschlager, Peter Ghosh, Andrew Zannettino, Mark Williamson, Jeffrey Victor Rosenfeld, Silviu Itescu, Graham Jenkin
Abstract: BACKGROUND: Rapid, reliable fusion is the goal in anterior cervical diskectomy and fusion. Iliac crest autograft has a high rate of donor-site morbidity. Alternatives such as bone graft substitutes lack osteoinductivity, and recombinant bone morphogenetic proteins risk life-threatening complications. Both allogeneic mesenchymal precursor cells (MPCs) and amnion derived epithelial cells (AECs) have osteogenic potential. OBJECTIVE: To compare for the first time the capacity of MPCs and AECs to promote osteogenesis in an ovine model. METHODS: Five groups of 2-year-old ewes were subjected to C3-4 anterior cervical diskectomy and fusion with a Fidji interbody cage packed with iliac crest autograft alone (group A; n = 6), hydroxyapatite-tricalcium phosphate Mastergraft granules (HA/TCP) alone (group B; n = 6), HA/TCP containing 5 million MPCs (group C; n = 6), or HA/TCP containing 5 million AECs (group D; n = 5); group E was made up of age-matched nonoperative controls (n = 6). At 3 months, animals were euthanized and quantitative multislice computed tomography, functional radiography, biomechanics, histology, and histomorphometry were performed. RESULTS: No procedure- or cell-related adverse events were observed. There was significantly more fusion in the MPC group (C) than in group A, B, or D. Computed tomography scan at 3 months revealed that 5 of 6 MPC-treated animals (83%) had continuous bony bridging compared with 0 of 5 AEC-treated and only 1 of 6 autograft- and 2 of 6 HA/TCP-treated animals (P = .01). CONCLUSION: Implantation of allogeneic MPCs in combination with HA/TCP within an interbody spacer facilitates interbody fusion after diskectomy. The earlier, more robust fusion observed with MPCs relative to autograft and HA/TCP bone substitute indicates that this approach may offer a therapeutic benefit.
Keywords: Amnion epithelial cell; Anterior cervical diskectomy and fusion; Biologics; Mesenchymal stem cell; Sheep; Spine fusion; Stem cells
Rights: Copyright © by the Congress of Neurological Surgeons
RMID: 0020103898
DOI: 10.1227/NEU.0b013e31820d5375
Appears in Collections:Medicine publications

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