Department of Orthopedic Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA.
Department of Orthopaedic Surgery, NYU Langone Health, New York, New York, USA.
World Neurosurg. 2022 Feb;158:182-188. doi: 10.1016/j.wneu.2021.11.130. Epub 2021 Dec 4.
Spinal fusion is the mainstay treatment for various spinal conditions ranging from lumbar and cervical stenosis to degenerative spondylolisthesis as well as extensive deformity corrections. A new emerging category of allograft is cellular bone matrices (CBMs), which take allogeneic mesenchymal stem cells and incorporate them into an osteoconductive and osteoinductive matrix. This study reviewed the current spinal fusion options and new emerging treatment options.
Articles were searched using PubMed. The search included English publications since January 1, 2014, using the search terms "cellular bone matrix," "mesenchymal stem cells spinal fusion," "spinal arthrodesis AND mesenchymal stem cells," and "spine fusion AND cellular bone matrix."
Spinal fusion is accomplished through the use of allografts, autografts, and bone graft substitutes in combination or alone. An emerging category of allograft is CBMs, in which an osteoconductive and osteoinductive matrix is filled with mesenchymal stem cells. Studies demonstrate that CBMs have achieved equivalent or better fusion rates compared with traditional options for anterior cervical discectomy and fusions and posterolateral lumbar fusions; however, the studies have been retrospective and lacking control groups and therefore not ideal.
Many treatment options have been successfully used in spinal fusion. Newer allografts such as CBMs have shown promising results in both animal and clinical studies. Further research is needed to determine the therapeutic dose of mesenchymal stem cells delivered within CBMs.
脊柱融合术是治疗各种脊柱疾病的主要方法，包括腰椎和颈椎狭窄、退行性脊椎滑脱以及广泛的畸形矫正。一种新兴的同种异体移植物是细胞骨基质 (CBM)，它采用异体间充质干细胞并将其整合到具有骨传导性和骨诱导性的基质中。本研究回顾了目前的脊柱融合选择和新出现的治疗选择。
使用 PubMed 搜索文章。搜索包括自 2014 年 1 月 1 日起的英文出版物，使用的搜索词为“细胞骨基质”、“间充质干细胞脊柱融合”、“脊柱关节融合术和间充质干细胞”以及“脊柱融合和细胞骨基质”。
脊柱融合是通过使用同种异体移植物、自体移植物和骨移植替代物单独或联合使用来实现的。一种新兴的同种异体移植物是 CBM，其中具有骨传导性和骨诱导性的基质中填充了间充质干细胞。研究表明，CBM 在治疗前路颈椎间盘切除和融合术以及后路腰椎融合术方面，与传统方法相比具有等效或更好的融合率；然而，这些研究是回顾性的，缺乏对照组，因此并不理想。
许多治疗选择已成功应用于脊柱融合。新型同种异体移植物如 CBM 在动物和临床研究中均显示出良好的效果。需要进一步研究以确定 CBM 内输送的间充质干细胞的治疗剂量。
