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Short-term alendronate treatment does not maintain a residual effect on spinal fusion with interbody devices and bone graft after treatment withdrawal: an experimental study on spinal fusion in pigs

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Abstract

Purpose

Whether alendronate treatment has a residual effect on bone ingrowth into porous biomaterial in humans or experimental animals after treatment withdrawal is still unknown. The purpose of this study was to investigate bone ingrowth into porous tantalum and carbon fiber interbody implants after discontinuing alendronate treatment in experimental spinal fusion in pigs.

Methods

Twenty-four pigs were randomly divided into two groups of each 12 pigs. The pigs underwent anterior intervertebral lumbar arthrodeses at L2–3, L4–5 and L6–7. Each level was randomly allocated to one of the three implants: a porous tantalum ring with pedicle screw fixation, a porous tantalum ring or a carbon fiber cage with anterior staple fixation. The central hole of implants was packed with an autograft. Alendronate was given orally for the first 3 months to one of the two groups. The pigs were observed for 6 months postoperatively. Histology and micro-CT scans were done at the endpoint.

Results

The spinal fusion rates of each implant showed no differences between two treatment groups. Furthermore, no differences were found between two groups as for bone ingrowth into the central holes of implants and bone–implant interface in each implant, or as for the pores of tantalum implants. Trabecular bone microarchitecture in the central hole of the carbon fiber cage did not differ between two treatment groups.

Conclusion

The application of ALN, with a dose equivalent to that given to humans during the first 3 months after surgery, does not maintain a residual effect on spinal fusion with porous tantalum ring and autograft after treatment withdrawal in a porcine ALIF model.

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Acknowledgments

The authors thank Anette Milton for technical assistance in histology, Bruce Robie, PhD, for excellent help in revising of the manuscript, and the Danish Institute of Agricultural Sciences, Research Center Foulum, for excellent cooperation. The Danish Rheumatism Association, the Institute of Experimental Clinical Research, University of Aarhus, and the Aarhus Spine Research Foundation in Denmark provided financial supports. This work was also supported by the Danish Council for Strategic Research project IMR: “Individualized musculoskeletal regeneration and reconstruction” (2101-07-0120), 973 Program (No. 2012CB619100), the NSFC (No. u0732001), and the S&T project of Guangdong Province (2010B010800019). Hedrocel ALIF devices (Porous Tantalum Implants) was kindly supplied by Implex Corp., Allendale, NJ, USA, for the study. The experiments complied with the Danish Law on Animal Experiments and were approved by the Danish Ministry of Justice, J. No. 1998-561-67.

Conflict of interest

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Authors and Affiliations

  1. Orthopaedic Research Laboratory, Spine Section/Department of Orthopaedics E, Aarhus University Hospital, 8000, Aarhus C, Denmark

    Baoding Huang, Xuenong Zou, Haisheng Li, Qingyun Xue & Cody Bünger

  2. Department of Spine Surgery/Orthopaedic Research Institute, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, #58, Building 1, Guangzhou, 510080, Guangdong, People’s Republic of China

    Baoding Huang & Xuenong Zou

  3. Department of Orthopaedics, The Sixth Affiliated Hospital of Sun Yat-sen University, Yuan cun Er Heng Road, #26, Guangzhou, 510655, Guangdong, People’s Republic of China

    Baoding Huang

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  1. Baoding Huang
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  2. Xuenong Zou
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  3. Haisheng Li
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  4. Qingyun Xue
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  5. Cody Bünger
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Corresponding author

Correspondence to Xuenong Zou.

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Huang, B., Zou, X., Li, H. et al. Short-term alendronate treatment does not maintain a residual effect on spinal fusion with interbody devices and bone graft after treatment withdrawal: an experimental study on spinal fusion in pigs. Eur Spine J 22, 287–295 (2013). https://doi.org/10.1007/s00586-012-2513-7

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  • DOI: https://doi.org/10.1007/s00586-012-2513-7

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