Kaohsiung Journal of Medical Sciences
Volume 26, Issue 7 , Pages 357-365, July 2010

Repair of the Canine Vertebral Lamina With a Combination of Autologous Micromorselized Bone and Poly-Lactic Acid Gel After a Total Laminectomy

Department of Orthopedic Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin, China

Received 12 October 2009; accepted 26 January 2010.

Article Outline

The complications of a total laminectomy can include epidural scar adhesion, secondary vertebral canal stenosis and lumbar instability. The aim of this study was to assess the ability of a combination of autologous micromorselized bone and polylactic acid (PLA) gel to stimulate bone repair within canine vertebral lamina defects, as well as to prevent peridural adhesion following a laminectomy. Twenty dogs underwent a L1, L3 and L5 laminectomy after a pre-computed tomography examination. The 60 laminectomies were divided into 4 groups, and underwent the following treatments: Group A were treated with a combination of autologous micromorselized bone and PLA gel (n = 16); Group B were treated with micromorselized bone only (n = 16); Group C with PLA gel only (n = 14); and Group D were left untreated as they were the blank controls (n = 14). Vertebral laminae were harvested at 4th and 8th weeks, and examined by computed tomography and histological staining. Significant bone regeneration was observed at 4 and 8 weeks in Groups A and B, although the newly formed bone in the latter group was more irregular in shape. Spinal canal cross-sectional areas in Group B decreased as compared with those in Group A(p < 0.05), and the degree of peridural adhesion in Groups A and C was significantly lower compared with Groups B and D (p < 0.05). These findings indicate that a combination of micromorselized bone and PLA gel may provide a better strategy for the treatment of spinal stenosis.

Key Words:  autologous micromorselized bone , bone regeneration , polylactic acid , spinal stenosis , total laminectomy

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References 

  1. Lawson KJ , Malycky JL , Berry JL , et al.   Lamina repair and replacement to control laminectomy membrane formation in dogs . Spine . 1991;16:222–225
  2. Hazlett JW , Kinnard P . Lumbar apophyseal process excision and spinal instability . Spine . 1982;7:171–176
  3. Vrankovic D , Splavski B , Hecimovic I , et al.   Spinous process-plasty following lumbar laminectomy as a contributing factor to spine stability . Arch Orthop Trauma Surg . 1996;115:211–215
  4. Hsu CJ , Chou WY , Teng HP , et al.   Coralline hydroxyapatite and laminectomy-derived bone as adjuvant graft material for lumbar posterolateral fusion . J Neurosurg Spine . 2005;3:271–275
  5. Magnus T . The morselized and impacted bone graft: animals experiments on proteins, impaction and load . Acta Orthop Scand . 2000;71(Suppl):1
  6. Xia JJ , Yan JL , Zhang ZP , et al.   Effect of morselized and bulk bone on bone marrow stromal cell . J Harbin Med Univ . 2003;36:141–143
  7. Liu HY , Tong XJ , Ying KM , et al.   Experimental study on osteogenesis of autogenous bone dust . Orthop J Chin . 1999;6:440–443
  8. Tägil M . The morselized and impacted bone graft. Animal experiments on proteins, impaction and load . Acta Orthop Scand Suppl . 2000;290:1–40
  9. Zhao TB , Fan QY , Zhang DZ , et al.   Preparation of decalcified bone matrix, bone cement and bone morphogenetic protein composite . Natl Med J China . 2005;81:1374–1376
  10. Songer MN , Ghosh L , Spencer DL . Effects of sodium hyaluronate on peridural fibrosis after lumbar laminectomy and discectomy . Spine . 1990;15:550–554
  11. Hou XK , Fan TY . The histological and ultrastructural studies of preventative effects of sodium hyaluronate on postoperative peridural fibrosis . Chin J Orthop . 1998;18:301–303
  12. Li GF , Wang MY , Jiang ZQ . Application of medical fibrin gel in intraspinal canal surgery . China Pract Med . 2002;4:60
  13. Cheng BQ , Chen YM , Long CY , et al.   Clinical application of medical chitosan in preventing postoperative cicatricial adhesion of lumbar disc herniation . Int Med Health Guid News . 2004;10:4–5
  14. Shi ZL , Wang YP , Dai G , et al.   CPP/PLLA composites of scaffolds for tissue engineering . Acta Mater Compos Sin . 2002;19:97–100
  15. Tang SQ , Mao X , Shi HT , et al.   Properties and application evaluation of laminated composite scaffolds of β-tricalcium phosphate/poly[L-lactic acid] . J Jinan Univ (Nat Sci & Med ed) . 2002;23:67–70
  16. Göpferich A , Peter SJ , Lucke A , et al.   Modulation of marrow stromal cell function using poly(D, L lactic acid)-block-poly(ethylene glyco1)-monomethyl ether surfaces . J Biomed Mater Ras . 1999;46:390–398
  17. Cao XB , Wang YL , Pan J , et al.   The change in mechanical properties of modified polylactide with maleic anhydride . Polymer Mater Sci Eng . 2002;18:115–118
  18. Cai KY , Yao KD , Hou X , et al.   Improvement of the functions of osteoblasts seeded on modified poly(D, L-lactic acid) with poly(aspartic acid) . J Biomed Mater Res . 2002;62:283–291
  19. Nuutinen  , Juha-Pekka  , Clerc  , et al.   Mechanical properties and in vitro degradation of bioabsorbable se1f-expanding braided stents . J Biomater Sci Polym Ed . 2003;14:255–266
  20. Smit TH , Krijnen MR , van Dijk M , et al.   Application of polylactides in spinal cages: Studies in a goat model . J Mater Sci Mater Med . 2006;17:1237–1244
  21. Lee JY , Ebel H , Friese M , et al.   Influence of Tachocomb in comparison to local hemostyptic agents on epidural fibrosis in a rat laminectomy model . Minim Invasive Neurosurg . 2003;46:106–109
  22. Rydell N , Balazs EA . Effect of intra-articular injection of hyaluronic acid on the clinical symptoms of osteoarthritis and on granulation tissue formation . Clin Orthop . 1971;80:25–32
  23. Che SC , Chen YS , Tzu CL . Scanning electron microscopy observation of vascularization around hydroxyapatite using vascular corrosion casts . J Biomed Mater Res . 1999;48:411–416
  24. Lind M . Growth factor stimulation of bone healing. Effects on osteoblasts, osteomies and implants fixation . Acta Orthop Scand Supp . 1998;283:2–37
  25. Liu LM , Song YM , Duan H , et al.   Experimental study on PLA gel for prevention of tendon adhesion . Orthop J Chin . 2004;12:225–227

PII: S1607-551X(10)70059-0

doi:10.1016/S1607-551X(10)70059-0

Kaohsiung Journal of Medical Sciences
Volume 26, Issue 7 , Pages 357-365, July 2010