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European Spine Journal

, Volume 14, Issue 7, pp 645–648 | Cite as

The vertebral interbody grafting site’s low concentration in osteogenic progenitors can greatly benefit from addition of iliac crest bone marrow

  • Mostafa Romih
  • Joël DelécrinEmail author
  • Dominique Heymann
  • Norbert Passuti
Original Article

Abstract

The ability of bone substitutes to promote bone fusion is contigent upon the presence of osteoinductive factors in the bone environment at the fusion site. Osteoblast progenitor cells are among these environmental osteoinductive factors, and one of the most abundant and available sources of osteoblastic cells is the bone marrow. As far as biological conditions are concerned, the vertebral interbody space appears as a favorable site for fusion, as it is surrounded by spongy bone, theoretically rich in osteogenic cells. This site may, however, not be as rich in osteogenic precursor cells especially at the time of grafting, because decortication of the vertebral end plates during the grafting process may modifiy cell content of the surrounding spongy bone. We tested this hypothesis by comparing the abundance of human osteogenic precursor cells in bone marrow derived from the iliac crest, the vertebral body, and the decorticated intervertebral body space. The number of potential osteoblast progenitors in each site was estimated by counting the alkaline phosphatase–expressing colony-forming units (CFU-AP). The results, however, demonstrate that the vertebral interbody space is actually poorer in osteoprogenitor cells than the iliac crest (P<0.001) and vertebral body (P<0.01), especially at the time of graft implantation. In light of our results, we advocate addition of iliac crest bone marrow aspirate to increase the success rate of vertebral interbody fusion.

Keywords

Bone substitutes Calcium phosphate ceramics Osteogenic precursor cells Spinal fusion 

References

  1. 1.
    Bruder SP, Fink DJ, Caplan AI (1994) Mesenchymal stem cells in bone development: bone repair and skeletal regeneration therapy. J Cell Biochem 56:283–294Google Scholar
  2. 2.
    Curylo LJ, Johnstone B, Petersilag CA, Janicki JA, Yoo JU (1999) Augmentation of spinal arthrodesis with autologous bone marrow in a rabbit: posterolateral spine fusion model. Spine 24:434–439CrossRefPubMedGoogle Scholar
  3. 3.
    Delécrin J, Deschamps C, Romih M, Heymann D, Passuti N (2001) Influence of bone environment on ceramic osteointegration in spinal fusion: comparison of bone-poor sites and bone-rich sites. Eur Spine J 10:S110–S113CrossRefGoogle Scholar
  4. 4.
    Einhorn TA (1995) Current concepts review: enhancement of fracture-healing. J Bone Joint Surg 77A:940–956Google Scholar
  5. 5.
    George FM, Hironoti N, Cynthia AB, Kirk AE (2001) Age and gender-related changes in the cellularity of human bone marrow and the prevalence of osteoblastic progenitors. J Orthop Res 19:117–125Google Scholar
  6. 6.
    Lukasz JC, Brian J, Cheryl AP, Joseph AJ, Jung UY (1999) Augmentation of spinal arthrodesis with autologous bone marrow in a rabbit posterolateral spine fusion model. Spine 24:434–439CrossRefPubMedGoogle Scholar
  7. 7.
    Muschler GF, Boehm C, Easley K (1997) Aspiration to obtain osteoblast progenitor cells from human bone marrow: the influence of aspiration volume. J Bone Joint Surg Am 79:1699–1709Google Scholar
  8. 8.
    Ohgushi H, Goldberg VM, Caplan AI (1989) Hetertopic osteogenesis in porous ceramics induced by marrow cells. J Orthop Res 7:568–578Google Scholar
  9. 9.
    Rickard DJ, Kassem M, Hefferan TE, Sakar G, SelsbergTC, Riggs BL (1996) Isolation and characterisation of osteoblast precursor cells from human bone marrow. J Bone Miner Res 11:312–324Google Scholar
  10. 10.
    Toquet L, Rohanizadeh R, Guicheux J, Couillaud S, Passuti N, Heymann D (1999) Osteogenic potential in vitro of human bone marrow cells cultured on macroporous biphsic calcium phosphate ceramic. J Biomed Mater Res 44:98–108Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Mostafa Romih
    • 1
  • Joël Delécrin
    • 1
    Email author
  • Dominique Heymann
    • 2
  • Norbert Passuti
    • 1
  1. 1.Department of Orthopaedic Surgery, Hôtel DieuUniversity Hospital of NantesNantesFrance
  2. 2.Laboratoire de physiopathologie de la Résorption Osseuse, Faculté de MédecineUniversity Hospital of NantesNantesFrance

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