Date of Award

Fall 2003

Document Type

Thesis - Restricted

Degree Name

Master of Science (MS)

Department

Biomedical Engineering

First Advisor

Toth, Jeffrey

Second Advisor

Harris, Gerald

Third Advisor

Wang, Mei

Abstract

Degenerative disc disease (DDD) of the spine is one degenerative condition that causes pain, debilitation, and affects the individuals' activity and functional level. Degenerative disc disease is costly. It is one of the most complicated conditions to manage. Several management methods have been used. Non-surgical treatments are usually not very successful. More invasive treatments are often prescribed. Among the different spine procedures, spinal fusion is one common solution to DDD. A bone graft or its substitute is required for the surgery. Because of its excellent biocompatibility, osteogenicity, and ability to provide structural integrity in the fusion site, autograft is the best choice for transplantation. The healing and incorporation of autograft are similar to the natural process of fracture healing (37). However, disadvantages and limitations are associated with its use. Clinicians and researchers therefore seek an alternative solution. The fundamental biologic processes that occur after an allograft is transplanted are similar to that in an autograft. The differences are only quantitative. The fact that an allograft originates from another individual raises the concern that it will elicit an immunologic response in the host causing: rejection and undesirable outcome. Even though it is less osteogenic and biocompatible, allograft is osteoconductive and is able to provide structural integrity. A large amount of research has been done on allograft to make it a substitute for autografts. Based on a pilot study that the problems related to osteogenicity and biocompatibility of allograft has been noted (44), this study was designed to see if a bone morphogenetic protein, when delivered in an appropriate carrier, would enable allografts to become a substitute for autografts. In the present study, an absorbable collagen sponge loaded with recombinant human bone morphogenetic protein-2 (rhBMP-2) was inserted into an allograft cylinder for transplantation in a canine two-level cervical spine fusion model. Two hypotheses will be tested here: 1) rhBMP-2 will increase the allograft incorporation and the rate of spine fusion; 2) rhBMP-2 will inhibit or completely eliminate the immunogenic response of the host to the allograft.

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