Effect of Teriparatide [rhPTH(1,34)] and Calcitonin on Intertransverse Process Fusion in a Rabbit Model.
STUDY DESIGN.: Randomized, double-blinded, placebo controlled animal study. OBJECTIVE.: To evaluate the effect of teriparatide and calcitonin after an intertransverse process spinal fusion in a rabbit model. SUMMARY OF BACKGROUND DATA.: It is widely recognized that some osteoporosis medications, inc...
| Publicado en: | Spine (03622436) Vol. 35; no. 2; pp. 146 - 153 |
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| Autores principales: | , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
1/15/2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105290044&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105290044 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03622436 1Y6 jtl: Spine (03622436) issn: 03622436 maglogo: N pubinfo: dt: 1/15/2010 vid: 35 iid: 2 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 105290044 2010533947 10.1097/BRS.0b013e3181b71a96 NLM20081509 105290044 ppf: 146 ppct: 7 formats: tig: atl: Effect of Teriparatide [rhPTH(1,34)] and Calcitonin on Intertransverse Process Fusion in a Rabbit Model. aug: au: Lehman RA Jr Dmitriev AE Cardoso MJ Helgeson MD Christensen CL Raymond JW Eckel TT Riew KD affil: From the *Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC; daggerDepartment of Veterinary Pathology, Armed Forces Institute of Pathology, Washington, DC; and double daggerDepartment of Orthopaedic Surgery, WA University School of Medicine, St. Louis, MO. sug: subj: Bone Remodeling Drug Effects Calcitonin Pharmacodynamics Lumbar Vertebrae Drug Effects Lumbar Vertebrae Surgery Parathyroid Hormones Pharmacodynamics Spinal Fusion Animal Studies Biomechanics Drug Effects Bone Transplantation Chi Square Test Diphosphonates Pharmacodynamics Rabbits Random Assignment Range of Motion Drug Effects Staining and Labeling Wound Healing Drug Effects ab: STUDY DESIGN.: Randomized, double-blinded, placebo controlled animal study. OBJECTIVE.: To evaluate the effect of teriparatide and calcitonin after an intertransverse process spinal fusion in a rabbit model. SUMMARY OF BACKGROUND DATA.: It is widely recognized that some osteoporosis medications, including bisphosphonates, can interfere with bone healing. Although prescribed frequently in the treatment of osteoporosis, the effect of teriparatide and calcitonin on spinal fusion has not been fully elucidated. We hypothesized that teriparatide, being the only anabolic medication for osteoporosis treatment, would have a beneficial effect on spine fusion. METHODS.: Fifty-one New Zealand white rabbits underwent a posterolateral L5-L6 intertransverse process arthrodesis using autogenous iliac crest bone graft. The rabbits were randomly divided into 3 groups. All animals received daily subcutaneous injections of group I (n = 17) 1 mL of saline placebo; group II (n = 17) 10 mug/kg/day of teriparatide; group III (n = 17) 14 IU/animal of calcitonin during the 8-week postoperative period. Postmortem analyses included manual palpation, radiographic, biomechanical, and histologic assessment. Three random 10x fields were examined/graded within the cephalad, middle, and caudal regions of each section (810 fields). Fusion quality was graded using the Emery histologic scale (0-7 based on fibrous/bone content of the fusion mass). RESULTS.: Histologic fusion rates for teriparatide averaged 86.7% and was significantly greater than the autograft control group (50%) (P = 0.033). Radiographically, there was a strong trend towards teriparatide being superior to the calcitonin group (85.7% vs. 56.3%, respectively; P = 0.07). The average Emery grading score was 5.99 +/- 1.46 SD for the autologous group and 6.26 +/- 0.93 SD for the teriparatide group (P = 0.031). Although not significant, the teriparatide group showed less motion in flexion/extension, lateral bending, and axial rotation. CONCLUSION.: Our results suggest that teriparatide enhances spinal fusion while calcitonin has a neutral effect. The teriparatide group had the best histologic fusion rate and Emery scores, while the calcitonin group was similar to the saline controls. Although not significant, the teriparatide group had a strong trend towards superior radiographic fusion over the calcitonin group. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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