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Regeneration of a spinal ligament after total lumbar disk arthroplasty in primates

Total disk arthroplasty (TDA) is a new procedure that replaces the intervertebral disk space with an artificial motion segment and necessitates the resection of the anterior longitudinal ligament (ALL). We assessed whether a collagen-based graft made from porcine small-intestine submucosa (SIS) can be used as a regenerative scaffold to restore the function and structure of the ALL in the lumbar spine. A total of 10 mature male baboons underwent TDA at L5-L6 using one of two treatments: (1) TDA only (n = 5) or (2) TDA combined with SIS (n = 5). Six months postoperatively, mock revision surgery was performed to assess tissue adhesions followed by non-destructive multidirectional flexibility testing of the spinal segment. The vertebral segments were then processed for histology. The tissue adhesion score was 2.8 +/- 0.8 in the TDA only group and 1.8 +/- 1.4 in the TDA-SIS group (p = 0.2). Segmental range of motion and the length of the neutral zone were similar in both groups. Histology showed that the SIS scaffold led to an organized ligamentous structure with a significantly (p = 0.027) higher thickness (2.18 +/- 0.25 mm) compared to the connective tissue structure in the TDA-only group (1.66 +/- 0.33 mm). We concluded that using a SIS bioscaffold after TDA did not lead to increased great vessel adhesion while its use facilitated the formation of highly organized ligamentous tissues. However, the SIS- induced and newly formed ligamentous tissue anterior to the spinal segment did not lead to a measurable limitation of spinal extension

Keywords : Animals,Arthroplasty,Biocompatible Materials,Intervertebral Disc,Intervertebral Disc Degeneration,Intestine,Small,Longitudinal Ligaments,Lumbar Vertebrae,Male,methods,Motion,Papio cynocephalus,physiology,Range of Motion,Articular,Regeneration,Spine,surgery,Swine,Tissue Adhesions,Tissue Scaffolds,, Spinal,Ligament,After, pain clinic leeds

Date of Publication : 2009

Authors : Cunningham BW;Berven SH;Hu N;Beatson HJ;De Deyne PG;McAfee PC;

Organisation : Department of Orthopedic Surgery, Union Memorial Hospital, Baltimore, MD, USA

Journal of Publication : Cells Tissues Organs

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/19365110

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