Mick Perez-Cruet, M.D.

Introduction: Lumbar spinal fusion surgery is performed to alleviated debilitating back pain symptoms due to a variety of spinal conditions including spondylolisthesis with or without spinal stenosis. Sources of bone graft can include autograph, allograft or bone substitutes. The BoneBac Press (Thompson MIS, Salem, NH) was developed to collect drilled local bone collected during the decompression and or approach (Figs. 1-3). This study analyzed the cost savings and effectiveness of collecting local bone, need for additional allograft, and fusion rates while preforming minimally invasive transforaminal lumbar interbody fusion (MITLIF).

Methods: A retrospective analysis was preformed of 93 patients who received MITLIF (using Thompson MIS TLIF system). One level MITLIF was preformed using the in 95% of patients. The amount of local autography collected using the BoneBac Press was recorded. The amount of additional allograph supplement was also recorded for each case and the ratio of autograph to allograph used (Figs. 4-8). The cost of each surgery was estimated based on the allograph savings.

Mick Perez-Cruet, M.D.

Introduction: Intervertebral disc (IVD) degeneration is characterized by the loss of nucleus pulposus (NP) leading to disc space collapse which is a common cause of low back pain (Fig. 1). Currently, degenerative disc disease (DDD) has no biological cure and human stem cell therapy is increasingly being considered for its treatment. However, stem cells alone may not be adequate to provide bio-mechanical disc height restoration. Disc restorative technology is being investigated that might restore the bio-mechanical function of the degenerated disc via a process of gradual tissue growth generated distraction (TGGD). Once disc height is restored the injection of nucleus pulposus cells (NPCs) can restore the biological function of the degenerated disc.

Methods: In this study, we investigated the feasibility of human umbilical cord mesenchymal stem cells (UC-MSCs) differentiated into NPCs invitro in an in-vivo rabbit model of DDD (Fig. 2). Histological, biochemical and gene expression analysis was preformed to determine the optimal cell for NP regeneration (Fig.3). Further finite element analysis was preformed of a mechanical technology called Annulo (MI4Spine LLC, Bloomfield, MI) used to achieve disc height restoration.

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