Use of a three-dimensional autologous transplant derived from osteo-differentiated adipose stem cells on patients undergoing lombar fusion through a minimally invasive transforaminal approach

Edward Fomekong 1 MD ; Denis Dufrane 2 MD, PhD; Bruno Vande Berg 3 MD, PhD; Christian Raftopoulos 1 MD, PhD Published in the journal : February 2017 Category : Neurochirurgie

Summary :

In 2016, the neurosurgery department of the Cliniques universitaires Saint-Luc, Brussels, published an application of a scaffold-free osteogenic three-dimensional (3D) graft made of adipose-derived mesenchymal stem cells (AMSCs) in patients undergoing minimally-invasive transforaminal lumbar interbody fusion (MI-TLIF). Three patients with degenerative spondylolisthesis were included in the study, one with Level 1 and two with Level 2 disease. In order to obtain AMSCs, fatty tissue was collected from the abdomen by means of liposuction and differentiated afterwards in our cell/tissue bank. Clinical outcomes, including the Oswestry Disability Index (ODI) and visual analog scale (VAS), as well as fusion status, were assessed preoperatively and for up to 12 months’ post-surgery. At 12 months, all four operated AMSC levels could be assessed (n= 4). Our results showed that Grade 3 fusion could be confirmed at two levels out of four. Mean VAS score improved from 8.3 to 2, and ODI also improved from 47% to 31%. No donor site complication was observed. This study demonstrated that a scaffold-free 3D graft made of AMSCs can be manufactured and used as a promising alternative for spinal fusion procedures. Nevertheless, further studies involving larger patient series are required in order to confirm the technique's effectiveness.

Key words

Adipose-derived mesenchymal stem cells, one graft, spondylolisthesis, transforaminal lumbar interbody fusion, fusion rate