Yonsei Med J.  2017 Mar;58(2):407-414. 10.3349/ymj.2017.58.2.407.

The Influences of Different Ratios of Biphasic Calcium Phosphate and Collagen Augmentation on Posterior Lumbar Spinal Fusion in Rat Model

• Kim KH
• Park JY
• Park HS
• Kim KS
• Chin DK
• Cho YE
• Kuh SU

• KMID: 2427131
• DOI: http://doi.org/10.3349/ymj.2017.58.2.407

Abstract

PURPOSE
To determine the influence of different ratios of hydroxyapatite (HA)/beta tricalcium phosphate (β-TCP) and collagen augmentation for posterior lumbar fusion in a rat model.
MATERIALS AND METHODS
We generated a posterior lumbar fusion model in 50 rats and divided it into five groups of equal number as follows; 1) autologous bone graft as group A, 2) 70% HA+30% β-TCP as group B, 3) 70% HA+30% β-TCP+collagen as group C, 4) 30% HA+70% β-TCP as group D, and 5) 30% HA+70% β-TCP+collagen as group E. Rats were euthanized at 12 weeks after surgery and fusion was assessed by manual palpation, quantitative analysis using microCT and histology.
RESULTS
The score of manual palpation was significantly higher in group C than group E (3.1±1.1 vs. 1.8±0.8, p=0.033). However, in terms of microCT analysis, group D showed significantly higher scores than group B (5.5±0.8 vs. 3.1±1.1, p=0.021). According to quantitative volumetric analysis, 30% HA+70% β-TCP groups (group D and E) showed significantly reduced fusion mass at 12 weeks after surgery (123±14.2, 117±46.3 vs. 151±27.3, p=0.008, 0.003, respectively). Collagen augmentation groups revealed superior results in terms of both microCT score and histologic grade.
CONCLUSION
A 7:3 HA/β-TCP ratio with collagen augmentation rather than a 3:7 HA/β-TCP ratio could be a more favorable graft substitute for lumbar spinal fusion. There was positive role of collagen as an adjunct for spinal bone fusion process.

Keyword

Biphasic calcium phosphate; collagen; fusion; rat; β-TCP; hydroxyapatite

MeSH Terms

Animals
*Bone Transplantation
Collagen/*administration & dosage
Hydroxyapatites/*administration & dosage
Palpation
Prostheses and Implants
Rats
Spinal Fusion/*methods
Transplantation, Autologous
X-Ray Microtomography
Hydroxyapatites
Collagen

Figure

• 

  Fig. 1 Representative microcomputed tomography axial and sagittal view sections of fusion masses from each group. (A) Autobone (group A) showed complete union without graft-bone interface. (B) 7:3 HA: β-TCP (group B) revealed relatively larger fusion mass but less incorporated into recipient lamina. (C) 7:3 HA: β-TCP+collagen (group C) showed little incorporation into lamina but more remaining fusion mass. (D) 3:7 HA: β-TCP (group D) showed reduced fusion mass but revealed good graft incorporation into recipient lamina. (E) 3:7 HA: β-TCP+collagen (group E) demonstrated excellent graft incorporation into recipient lamina. HA, hydroxyapatite; β-TCP, beta tricalcium phosphate.

• 

  Fig. 2 Representative histologic features of fusion mass on goldner's trichrome staining. (A) Immature bone with narrow trabecular was formed along the cutting surface of bone defect (group A). (B) Peripheral bone resorption, new bone formation, and closure of cortex were minimal in comparison with other group (group B), (C) intermediate structural stability of fusion mass but less resorption than group D and E (group C). (D) Less distinctive features between graft and laminar bone and superior integration into recipient bone were shown, and reduced volume of fusion mass was also noted (group D). (E) There was excellent incorporation of graft into laminar bone but much less volume of fusion mass due to excessive resorption (group E).

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