Autologous Bone Marrow Concentrate in Elective Tranforaminal Lumbar Interbody Fusion Surgery
Study Details
Study Description
Brief Summary
This study aims to evaluate the effect of bone marrow concentration on bone healing and spinal fusion by comparing clinical and imaging outcomes between patients receiving transforaminal lumbar intebody fusion with local bone graft and with intraoperative bone marrow concentration and those receiving transforaminal lumbar intebody fusion with local bone graft only.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Spinal arthrodesis has become the mainstay of treatment for severe spinal deformity, spinal instability, spondylolisthesis, and symptomatic degenerative disease. Its primary goal is to develop an osseous bridge between adjacent motion segments to prevent motion, relieve pain, and facilitate neurological recovery. One of the arthrodesis method is transforaminal lumbar intebody fusion. After removal of the problematic disc, iliac crest bone graft was harvested and impacted into the space with cage to facilitate fusion. However, patients are exposed to additional risk of harvesting site, such as pain, infection, wound healing problem or hematomas. Local bone graft harvested from decompression is one of the alternative solutions to avoid these complications. However, the effect of local boen graft is inferior to iliac crest bone graft because iliac crest bone graft contains three important ingredients for successful fusion: osteoconductive scaffold, osteoinductive factors, and the ability to osteogenesis. Mesenchymal stem cells (MSCs) are pluripotent cells that can differentiate into multiple mesenchymal tissues, including tenocytes, chondrocytes and osteoblasts, as well as being a source of multiple growth factors to establish an environment conducive to soft and hard tissue regeneration. As bone marrow concentration has high concentration of mesenchymal stem cells, some studies have shown that autologous bone marrow concentration can improve bone healing. In this study, we will add bone marrow concentration into local bone graft during transforaminal lumbar intebody fusion and evaluate the effect of bone marrow concentration on bone healing and spinal fusion.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Bone marrow concentration group Transforaminal lumbar interbody fusion with local bone graft and intraoperative bone marrow concentration |
Other: Transforaminal lumbar interbody fusion with local bone graft and intraoperative bone marrow concentration
Transforaminal lumbar interbody fusion with local bone graft and intraoperative bone marrow concentration
|
| Active Comparator: Control group Transforaminal lumbar interbody fusion with local bone graft |
Other: Transforaminal lumbar interbody fusion with local bone graft
Transforaminal lumbar interbody fusion with local bone graft
|
Outcome Measures
Primary Outcome Measures
- 3-month postoperative spinal function evaluated by Oswestry Disability Index [3-month postoperative]
Subjective evaluation of spinal function by Oswestry Disability Index. Oswestry Disability Index ranges from 0 to 100 and lower score indicates less disability.
Secondary Outcome Measures
- 6-month postoperative spinal function evaluated by Oswestry Disability Index [6-month postoperative]
Subjective evaluation of spinal function by Oswestry Disability Index. Oswestry Disability Index ranges from 0 to 100 and lower score indicates less disability.
- 12-month postoperative spinal function evaluated by Oswestry Disability Index [12-month postoperative]
Subjective evaluation of spinal function by Oswestry Disability Index. Oswestry Disability Index ranges from 0 to 100 and lower score indicates less disability.
- 3-month postoperative degree of pain evaluated by visual analogue scale [3-month postoperative]
Subjective evaluation of degree of pain by visual analogue scale. Visual analogue scale for pain ranges from 0 to 10 and higher score indicates more pain.
- 6-month postoperative degree of pain evaluated by visual analogue scale [6-month postoperative]
Subjective evaluation of degree of pain by visual analogue scale. Visual analogue scale for pain ranges from 0 to 10 and higher score indicates more pain.
- 12-month postoperative degree of pain evaluated by visual analogue scale [12-month postoperative]
Subjective evaluation of degree of pain by visual analogue scale. Visual analogue scale for pain ranges from 0 to 10 and higher score indicates more pain.
- 3-month postoperative degree of bone healing evaluated by plain radiograph [3-month postoperative]
Degree of bone healing evaluated by plain radiograph
- 6-month postoperative degree of bone healing evaluated by plain radiograph [6-month postoperative]
Degree of bone healing evaluated by plain radiograph
- 12-month postoperative degree of bone healing evaluated by plain radiograph [12-month postoperative]
Degree of bone healing evaluated by plain radiograph
- 12-month postoperative degree of bone healing evaluated by computed tomograph [12-month postoperative]
Degree of bone healing evaluated by computed tomograph
Eligibility Criteria
Criteria
Inclusion Criteria:
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With indication of transforaminal lumbar decomprassion and interbody fusion, ex. spondylolisthesis, symptomatic degenerative disease, spinal instability.
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Involved levels between T12 and S1
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Involved levels less than three levels
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Age between 20 and 70 years
Exclusion Criteria:
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With prior history of spinal surgery
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With current or prior history of tumor, trauma or infection at spine
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With current diagnosis of coagulopathy
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With current or prior history of cancer
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With current or prior history of hematological disease
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Pregnancy
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Patients who will not cooperate with one-year followup
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Show Chwan Memorial Hospital | Changhua City | Changhua | Taiwan | 500 |
Sponsors and Collaborators
- Pei-Yuan Lee, MD
- Aeon Biotechnology Corporation
Investigators
- Study Chair: Pei-Yuan Lee, MD, Show Chwan Memorial Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- RD106050