Epidermal growth factor enhances spinal fusion: Posterolateral lumbar fusion model on rats

Objective: The aim of this study was to investigate the effects of human recombinant epidermal growth factor (EGF) on posterolateral lumbar fusion in a rat model. Methods: 36 male Sprague Dawley rats underwent posterolateral fusion at L4-5 level. They were randomly assigned to 3 groups: 1- Sham cont...

Full description

Saved in:
Bibliographic Details
Main Authors: Engin Çetin, İsmail Daldal, Ali Eren, Saadet Özen Akarca Dizakar, Suna Ömeroğlu, Bora Uzuner, Hakan Hamdi Çelik, Hasan Hüseyin Saygılı, Benat Koçkar, Alpaslan Şenköylü
Format: Article
Language:English
Published: AVES 2019-03-01
Series:Acta Orthopaedica et Traumatologica Turcica
Online Access:http://www.sciencedirect.com/science/article/pii/S1017995X18304346
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849407651777085440
author Engin Çetin
İsmail Daldal
Ali Eren
Saadet Özen Akarca Dizakar
Suna Ömeroğlu
Bora Uzuner
Hakan Hamdi Çelik
Hasan Hüseyin Saygılı
Benat Koçkar
Alpaslan Şenköylü
author_facet Engin Çetin
İsmail Daldal
Ali Eren
Saadet Özen Akarca Dizakar
Suna Ömeroğlu
Bora Uzuner
Hakan Hamdi Çelik
Hasan Hüseyin Saygılı
Benat Koçkar
Alpaslan Şenköylü
author_sort Engin Çetin
collection DOAJ
description Objective: The aim of this study was to investigate the effects of human recombinant epidermal growth factor (EGF) on posterolateral lumbar fusion in a rat model. Methods: 36 male Sprague Dawley rats underwent posterolateral fusion at L4-5 level. They were randomly assigned to 3 groups: 1- Sham control group where no local augmentation was made, 2- Local Hydoxyapatite β-tricalcium phosphate (HA/β-TCP) augmentation group and 3- Local HA/β-TCP + EGF augmentation group. Rats were euthanized at 8 weeks post-surgery. 6 rats from each group were selected for manual palpation examination, micro-computed tomography analysis and histologic analysis; and the rest was used for biomechanical analysis. Results: Based on manual palpation, there was no fusion in the sham control group. Fusion rate was 33.3% in the HA/β-TCP group and 66.7% in the HA/β-TCP + EGF group (p = 0.085). Micro-CT results revealed that new bone formation was higher in the HA/β-TCP + EGF group (BV/TV: 40% vs. 65%) (p = 0.004). Histologically newly formed bone tissue was more pronounced in the EGF group and compacted and bridging bone spicules were observed. The median maximum bending moment values were 0.51 Nmm (0.42–0.59), 0.73 Nmm (0.49–0.88) and 0.91 Nmm (0.66–1.03) in the sham control, HA/β-TCP and HA/β-TCP + EGF groups, respectively (p = 0.013). The median stiffness values were 1.69 N/mm (1.12–2.18), 1.68 N/mm (1.13–2.74) and 3.10 N/mm (1.66–4.40) as in the previous order (p = 0.087). Conclusion: This study demonstrates that EGF enhances posterolateral lumbar fusion in the rat model. EGF in combination with ceramic grafts increased the fusion rates. Our findings may provide insights to further studies, investigating EGF's clinical usage as an alternative fusion enhancer. Keywords: Epidermal growth factor, Spinal fusion, Bone formation, Posterolateral fusion, Rat model
format Article
id doaj-art-b59dc3cbd1d943a88d1c656819ec5a88
institution Kabale University
issn 1017-995X
language English
publishDate 2019-03-01
publisher AVES
record_format Article
series Acta Orthopaedica et Traumatologica Turcica
spelling doaj-art-b59dc3cbd1d943a88d1c656819ec5a882025-08-20T03:35:58ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2019-03-0153213413910.1016/j.aott.2019.01.005Epidermal growth factor enhances spinal fusion: Posterolateral lumbar fusion model on ratsEngin Çetin0İsmail Daldal1Ali Eren2Saadet Özen Akarca Dizakar3Suna Ömeroğlu4Bora Uzuner5Hakan Hamdi Çelik6Hasan Hüseyin Saygılı7Benat Koçkar8Alpaslan Şenköylü9Department of Orthopaedics and Traumatology, Gaziosmanpaşa Taksim Training and Research Hospital, Istanbul, Turkey; Corresponding author. Department of Orthopaedics and Traumatology, Gaziosmanpaşa Taksim Training and Research Hospital, Karayolları Mahallesi, Osmanbey Caddesi, 621 Sokak, 34255 Gaziosmanpaşa/İstanbul, Turkey. Tel.: +90 2129453000; fax: +90 2129453180.Department of Orthopaedics and Traumatology, Gazi University Faculty of Medicine, Ankara, TurkeyDepartment of Orthopaedics and Traumatology, Gazi University Faculty of Medicine, Ankara, TurkeyDepartment of Histology and Embryology, Gazi University Faculty of Medicine, Ankara, TurkeyDepartment of Histology and Embryology, Gazi University Faculty of Medicine, Ankara, TurkeyDepartment of Anatomy, Hacettepe University Faculty of Medicine, Ankara, TurkeyDepartment of Anatomy, Hacettepe University Faculty of Medicine, Ankara, TurkeyDepartment of Mechanical Engineering, Hacettepe University, Ankara, TurkeyDepartment of Mechanical Engineering, Hacettepe University, Ankara, TurkeyDepartment of Orthopaedics and Traumatology, Gazi University Faculty of Medicine, Ankara, TurkeyObjective: The aim of this study was to investigate the effects of human recombinant epidermal growth factor (EGF) on posterolateral lumbar fusion in a rat model. Methods: 36 male Sprague Dawley rats underwent posterolateral fusion at L4-5 level. They were randomly assigned to 3 groups: 1- Sham control group where no local augmentation was made, 2- Local Hydoxyapatite β-tricalcium phosphate (HA/β-TCP) augmentation group and 3- Local HA/β-TCP + EGF augmentation group. Rats were euthanized at 8 weeks post-surgery. 6 rats from each group were selected for manual palpation examination, micro-computed tomography analysis and histologic analysis; and the rest was used for biomechanical analysis. Results: Based on manual palpation, there was no fusion in the sham control group. Fusion rate was 33.3% in the HA/β-TCP group and 66.7% in the HA/β-TCP + EGF group (p = 0.085). Micro-CT results revealed that new bone formation was higher in the HA/β-TCP + EGF group (BV/TV: 40% vs. 65%) (p = 0.004). Histologically newly formed bone tissue was more pronounced in the EGF group and compacted and bridging bone spicules were observed. The median maximum bending moment values were 0.51 Nmm (0.42–0.59), 0.73 Nmm (0.49–0.88) and 0.91 Nmm (0.66–1.03) in the sham control, HA/β-TCP and HA/β-TCP + EGF groups, respectively (p = 0.013). The median stiffness values were 1.69 N/mm (1.12–2.18), 1.68 N/mm (1.13–2.74) and 3.10 N/mm (1.66–4.40) as in the previous order (p = 0.087). Conclusion: This study demonstrates that EGF enhances posterolateral lumbar fusion in the rat model. EGF in combination with ceramic grafts increased the fusion rates. Our findings may provide insights to further studies, investigating EGF's clinical usage as an alternative fusion enhancer. Keywords: Epidermal growth factor, Spinal fusion, Bone formation, Posterolateral fusion, Rat modelhttp://www.sciencedirect.com/science/article/pii/S1017995X18304346
spellingShingle Engin Çetin
İsmail Daldal
Ali Eren
Saadet Özen Akarca Dizakar
Suna Ömeroğlu
Bora Uzuner
Hakan Hamdi Çelik
Hasan Hüseyin Saygılı
Benat Koçkar
Alpaslan Şenköylü
Epidermal growth factor enhances spinal fusion: Posterolateral lumbar fusion model on rats
Acta Orthopaedica et Traumatologica Turcica
title Epidermal growth factor enhances spinal fusion: Posterolateral lumbar fusion model on rats
title_full Epidermal growth factor enhances spinal fusion: Posterolateral lumbar fusion model on rats
title_fullStr Epidermal growth factor enhances spinal fusion: Posterolateral lumbar fusion model on rats
title_full_unstemmed Epidermal growth factor enhances spinal fusion: Posterolateral lumbar fusion model on rats
title_short Epidermal growth factor enhances spinal fusion: Posterolateral lumbar fusion model on rats
title_sort epidermal growth factor enhances spinal fusion posterolateral lumbar fusion model on rats
url http://www.sciencedirect.com/science/article/pii/S1017995X18304346
work_keys_str_mv AT engincetin epidermalgrowthfactorenhancesspinalfusionposterolaterallumbarfusionmodelonrats
AT ismaildaldal epidermalgrowthfactorenhancesspinalfusionposterolaterallumbarfusionmodelonrats
AT alieren epidermalgrowthfactorenhancesspinalfusionposterolaterallumbarfusionmodelonrats
AT saadetozenakarcadizakar epidermalgrowthfactorenhancesspinalfusionposterolaterallumbarfusionmodelonrats
AT sunaomeroglu epidermalgrowthfactorenhancesspinalfusionposterolaterallumbarfusionmodelonrats
AT borauzuner epidermalgrowthfactorenhancesspinalfusionposterolaterallumbarfusionmodelonrats
AT hakanhamdicelik epidermalgrowthfactorenhancesspinalfusionposterolaterallumbarfusionmodelonrats
AT hasanhuseyinsaygılı epidermalgrowthfactorenhancesspinalfusionposterolaterallumbarfusionmodelonrats
AT benatkockar epidermalgrowthfactorenhancesspinalfusionposterolaterallumbarfusionmodelonrats
AT alpaslansenkoylu epidermalgrowthfactorenhancesspinalfusionposterolaterallumbarfusionmodelonrats