Department of Orthopaedic Surgery, Texas Children's Hospital, Houston, TX.
Department of Orthopedic Surgery, Sohag University, Egypt.
Spine (Phila Pa 1976). 2017 Dec 15;42(24):1871-1879. doi: 10.1097/BRS.0000000000002255.
Retrospective study.
The aim of this study was to evaluate the long-term clinical and radiological outcomes of the use of bone marrow mesenchymal stem cell concentrate obtained with selective cell retention technology using Cellect with a particular collagen scaffold, Healos for posterolateral spinal fusion.
With the increasing rate of spinal fusion, the problem of pseudarthrosis, which contributes to recurrent pain with patient disability, is considered to be the most common cause of revision lumbar spine surgery. Intensive research is being carried out to develop an alternative source of bone grafting and improve the spinal fusion rate.
A retrospective review of hospital records was performed. Identified patients were contacted to have a clinical and radiological evaluation follow-up. Clinical outcome was evaluated using visual analog scales for the back pain (VAS), Oswestry Disability Index (ODI) scores, and quality of life (EQ-5D) questionnaire. Radiological outcome was evaluated by performing dynamic flexion/extension lateral views and calculation of segmental Cobb angle. Any implant-associated complication was reported. Computed tomography (CT) scans were also performed.
Twenty-one patients were included and all patients achieved successful fusion. The mean difference of the segmental Cobb angle was 0.48° (range 0.3°-0.7°). Computed tomography scans showed solid bilateral fusion with bridging bone (Grade I) in all patients, but solid unilateral fusion with bridging bone (Grade II) was detected for one patient at one level. Patients started to resume working activities within a mean period of 3.5 months. The VAS score for the residual back pain was 4.1 ± 2.1, whereas the ODI was 10.5 ± 5.6 points, and the mean disability index was 21.1%.
The use of bone marrow mesenchymal stem cell concentrate obtained with selective cell retention technology could be considered as an effective means for augmenting spinal fusion.
回顾性研究。
本研究旨在评估使用 Cellect 选择性细胞保留技术获取的骨髓间充质干细胞浓缩物与特定胶原支架 Healos 联合应用于后路脊柱融合的长期临床和影像学结果。
随着脊柱融合率的不断提高，假关节形成的问题，即导致患者残疾的复发性疼痛，被认为是腰椎翻修手术最常见的原因。目前正在进行大量研究，以开发替代骨移植来源并提高脊柱融合率。
对医院病历进行回顾性审查。联系已识别的患者进行临床和影像学随访评估。使用背部疼痛视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）评分和生活质量（EQ-5D）问卷评估临床结果。通过进行动力屈伸侧位片并计算节段 Cobb 角评估影像学结果。报告任何与植入物相关的并发症。还进行了计算机断层扫描（CT）检查。
共纳入 21 例患者，所有患者均获得成功融合。节段 Cobb 角的平均差值为 0.48°（范围 0.3°-0.7°）。CT 扫描显示所有患者均存在双侧融合伴桥接骨（Grade I），但 1 例患者在 1 个节段存在单侧融合伴桥接骨（Grade II）。患者平均在 3.5 个月内开始恢复工作活动。残留背部疼痛的 VAS 评分为 4.1±2.1，ODI 为 10.5±5.6 分，平均残疾指数为 21.1%。
使用选择性细胞保留技术获取的骨髓间充质干细胞浓缩物可被视为增强脊柱融合的有效手段。
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