Effectiveness of Posterolateral Lumbar Fusion Varies with the Physical Properties of Demineralized Bone Matrix Strip

• Main Authors: Yong-Soo Choi, Dae-Hee Kim, Ji-Hun Park, Brian Johnstone, Jung-U Yoo
• Format: Article
• Language: English
• Published: Korean Spine Society 2015-06-01
• Series: Asian Spine Journal
• Subjects: Demineralized bone matrix; Spinal fusion
• Online Access: http://www.asianspinejournal.org/upload/pdf/asj-9-433.pdf

Study DesignA randomized, controlled animal study.PurposeTo investigate the effectiveness of fusion and new bone formation induced by demineralized bone matrix (DBM) strips with jelly strengths.Overview of LiteratureThe form of the DBM can make a difference to the outcome. The effect of different jelly strengths on the ability of DBM to form new bone is not known.MethodsForty-eight rabbits were randomized into a control group and two experimental groups. In the control group (group 1), 1.4 g of autologous iliac crest bone was placed bilaterally. In the experimental groups, a high jelly strength DBM-hyaluronic acid (HA)-gelatin strip (group 2) and a low jelly strength DBM-HA-gelatin strip (group 3) were used. The fusion was assessed with manual manipulation and radiographs. The volume of the fusion mass was determined from computed tomographic images.ResultsThe fusion rates as determined by manual palpation were 37.5%, 93.8% and 50.0% in group 1, group 2, and group 3, respectively (p<0.05). By radiography, the fusion rate of High jelly strength DBM strip was statistically significantly greater than that of the other alternatives (p<0.05). The mean bone volume of the fusion mass as determined by computed tomography was 2,142.2±318.5 mm3, 3,132.9±632.1 mm3, and 2,741.5±380.4 mm3 in group 1, group 2, and group 3, respectively (p<0.05).ConclusionsThese results indicate that differences in the structural and mechanical properties of gelatin that are associated with jelly strength influenced cellular responses such as cell viability and bony tissue ingrowth, facilitating greater bone fusion around high jelly strength implants.