The Safety of OP-1 for Lumbar Fusion with Decompression - a Canine Study

The Safety of OP-1 for Lumbar Fusion with Decompression - a Canine Study AbstractOBJECTIVEBone morphogenetic proteins can serve as adjuncts to autologous bone to achieve bony fusion, and recombinant BMPs such as osteogenic protein-1 (OP-1) have the potential to replace autologous bone altogether as fusion substrate. However, relatively little is known about the safety of OP-1 for spinal fusion procedures. This study examined the effects of OP-1 intentionally placed in the subarachnoid space following thecal sac decompression, and used as graft substrate in a canine dorsolateral lumbar spine fusion model.METHODSLumbar decompression with dorsolateral fusion was performed on 30 canines. The dura was opened to simulate an intraoperative rent and OP-1 was placed in the subarachnoid space and in the fusion bed. Animals were sacrificed after 16 weeks and the spines were examined manually, radiographically and pathologically.RESULTSAll animals treated with OP-1 developed new bone in the subarachnoid space. This bone compressed the spinal cord, but no clinical or pathological features of neurotoxicity were noted. Mild spinal stenosis was noted at the site of dural decompression in the OP-1 treated animals. Over 80% of animals treated with OP-1 developed fusion as assessed by palpation (52% by CT criteria), while only 25% of control animals fused.CONCLUSIONRecombinant human OP-1 is effective at promoting fusion in a canine dorsolateral lumbar spine fusion model. However, bone growth can occur over exposed, decompressed dura, and it can form in the subdural and subarachnoid spaces. The use of OP-1 as an adjunct to spinal fusion appears to have merit, but its use must be carefully controlled to avoid unwanted bone formation and subsequent neural compression. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

The Safety of OP-1 for Lumbar Fusion with Decompression - a Canine Study

The Safety of OP-1 for Lumbar Fusion with Decompression - a Canine Study

at The Safety of OP-1 for Lumbar Fusion ru r; anc with Decompression - a Canine Study rec C h r i s t o p h e r G . P a r a m o r e , M . D . , C a r l L a u r y s s e n , M . D . , M i c h a e l E r J . R a u z z i n o , M . D . , V a n R . W a d l i n g t o n , M . D . , C h e r y l A . P a l m e r , M . D . , A m y B r i x , D . V . M . , S a m u e l C . C a r t n e r , D . V . M . a n d M a r k N . H a d l e y , M . D . 891- Departments of Surgery (Neurosurgery) (C G P , MJR, M N H ), Radiology (V R W ), Pathology (C A P ), and C o m p arative M e d ic in e (A B, S C O , The U niversity of Alabam a at Birm ingham , Birm ingham , A la b a m a , and Department of Neurosurgery (CL), W ashington U n iversity School of M edicine, St. Louis, Missouri tk ani bet OBJECTIVE: Bone m o r p h o g e n e t i c p r o t e i n s c a n serve as a d ju n c t s to a u t o l o g o u s b o n e to a c h i e v e b o n y f u s i o n , tk and recombinant B M P s s u c h as o s t e o g e n i c protein-1 ( O P - 1 ) have the p o t e n t ia l to r e p l a c e a u t o l o g o u s b o n e ji altogether as fusion s u b s t r a t e . H o w e v e r , relatively little is known a b o u t the safety o f O P -1 for s p in a l ti' fusion p roce d u re s. This study e x a m i n e d the effects of OP-1 i n t e n tio n a lly p l a c e d in th e s u b a r a c h n o i d chi space following t h e c a l s a c d e c o m p r e s s i o n , and used as graft su b str a te in a c a n i n e d o r s o l a t e r a l l u m b a r spine fusion m o d e l . METHODS: Lumbar d e c o m p r e s s i o n with d o r s o l a t e r a l fusion was p e r f o r m e d on 3 0 c a n i n e s . The dura w as ?u r opened to sim u la te an i n t r a o p e r a t i v e re n t and OP-1 was p la c e d in the s u b a r a c h n o i d s p a c e and in the rle fusion bed. A n i m a l s w e r e s a c r i f i c e d after 1 6 weeks and the spines w e r e e x a m i n e d m a n u a l l y , radiographically and p a t h o l o g i c a l l y ....
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199905000-00134
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVEBone morphogenetic proteins can serve as adjuncts to autologous bone to achieve bony fusion, and recombinant BMPs such as osteogenic protein-1 (OP-1) have the potential to replace autologous bone altogether as fusion substrate. However, relatively little is known about the safety of OP-1 for spinal fusion procedures. This study examined the effects of OP-1 intentionally placed in the subarachnoid space following thecal sac decompression, and used as graft substrate in a canine dorsolateral lumbar spine fusion model.METHODSLumbar decompression with dorsolateral fusion was performed on 30 canines. The dura was opened to simulate an intraoperative rent and OP-1 was placed in the subarachnoid space and in the fusion bed. Animals were sacrificed after 16 weeks and the spines were examined manually, radiographically and pathologically.RESULTSAll animals treated with OP-1 developed new bone in the subarachnoid space. This bone compressed the spinal cord, but no clinical or pathological features of neurotoxicity were noted. Mild spinal stenosis was noted at the site of dural decompression in the OP-1 treated animals. Over 80% of animals treated with OP-1 developed fusion as assessed by palpation (52% by CT criteria), while only 25% of control animals fused.CONCLUSIONRecombinant human OP-1 is effective at promoting fusion in a canine dorsolateral lumbar spine fusion model. However, bone growth can occur over exposed, decompressed dura, and it can form in the subdural and subarachnoid spaces. The use of OP-1 as an adjunct to spinal fusion appears to have merit, but its use must be carefully controlled to avoid unwanted bone formation and subsequent neural compression.

Journal

NeurosurgeryOxford University Press

Published: May 1, 1999

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