PubMed Health⌕ Search

Biomedical subjects

F C Oner

Publications and source records attributed to F C Oner.

At least 19 recordsLinked to original sources

Application and limitations of chloromethyl-benzamidodialkylcarbocyanine for tracing cells used in bone Tissue engineering.

Bone tissue engineering has the potential to provide us with an autologous bone substitute. Despite extensive research to optimize the technique, little is known about the survival and function of the cells after implantation. To monitor the cells, in vivo labeling is the method of choice. In this study we investigated the use of the fluorescent membrane marker chloromethyl-benzamidodialkylcarbocyanine (CM-Dil) to label cells used in bone tissue engineering. When applying label concentrations up to 50 microM, cells could be labeled efficiently without negative effects on cell vitality, proliferation, or bone-forming capacity. Porous hydroxyapatite scaffolds were seeded with labeled cells, and up to 6 weeks after implantation in nude mice cells could be traced inside tissue-engineered bone. However, contrary to other reports concerning intramembranous labels, transfer of the label from labeled to unlabeled cells was detected. Transfer occurred both in vitro and in vivo between vital cells and between dead and living cells. To determine when in vivo label transfer happened, devitalized, labeled constructs were implanted for various time periods in nude mice. The presence of vital labeled cells inside these constructs, when evaluated at different implantation periods, indicated transfer of the label. Transfer occurred at 7 days postimplantation when 40 microM label was applied, whereas 10 microM labeled constructs showed transfer 10 days after implantation. These findings indicate that CM-Dil label is useful for in vivo tracing of cells for follow-up periods up to 10 days. This makes the label particularly useful for cell survival studies in tissue-engineered implants.

Bone and Bones↗

Viable osteogenic cells are obligatory for tissue-engineered ectopic bone formation in goats.

In this study we investigated the bone-forming capacity of tissue-engineered (TE) constructs implanted ectopically in goats. As cell survival is questionable in large animal models, we investigated the significance of vitality, and thus whether living cells instead of only the potentially osteoinductive extracellular matrix are required to achieve bone formation. Vital TE constructs of porous hydroxyapatite (HA) covered with differentiated bone marrow stromal cells (BMSCs) within an extracellular matrix (ECM) were compared with identical constructs that were devitalized before implantation. The devitalized implants did contain the potentially osteoinductive ECM. Furthermore, we evaluated HA impregnated with fresh bone marrow and HA only. Two different types of HA granules with a volume of approximately 40 microm were investigated: HA70/800, a microporous HA with 70% interconnected macroporosity and an average pore size of 800 microm, and HA60/400, a smooth HA with 60% interconnected macropores and an average size of 400 microm. Two granules of each type were combined and then treated as a single unit for cell seeding, implantation, and histology. The tissue-engineered samples were obtained by seeding culture-expanded goat BMSCs on the HA and subsequently culturing these constructs for 6 days to allow cell differentiation and ECM formation. To devitalize, TE constructs were frozen in liquid nitrogen according to a validated protocol. Fresh bone marrow impregnation was performed perioperatively (4 mL per implant unit). All study groups were implanted in bilateral paraspinal muscles. Fluorochromes were administered at three time points to monitor bone mineralization. After 12 weeks the units were explanted and analyzed by histology of nondecalcified sections. Bone formation was present in all vital tissue-engineered implants. None of the other groups showed any bone formation. Histomorphometry indicated that microporous HA70/800 yielded more bone than did HA60/400. Within the newly formed bone, the fluorescent labels showed that mineralization had occurred before 5 weeks of implantation and was directed from the HA surface toward the center of the pores. In conclusion, tissue-engineered bone formation in goats can be achieved only with viable constructs of an appropriate scaffold and sufficient BMSCs.

Animals↗

Total disc replacement for chronic low back pain: background and a systematic review of the literature.

In this paper the rationale for total disc replacement is discussed, and the authors suggest seven requirements that should be met before the implantation of these devices can be accepted as regular procedures. In an attempt to answer the questions raised, a systematic literature search was performed. The search yielded no controlled trials and nine case series with a total of 564 arthroplasties in 411 patients. The devices used were SB Charité in eight and Acroflex in one study. The percentage results classified as "good" or "excellent" in the studies varied from 50 to 81%. Complications were observed in 3-50% of the patients. Twenty-two of the operated levels were fused either spontaneously or after additional surgery. A meta-analysis to compare the results with other treatments could not be performed due to the lack of comparative studies. Despite the fact that these devices have been implanted for almost 15 years, on the basis of this literature survey there are currently insufficient data to assess the performance of total disc replacement adequately. There is no evidence that disc replacement reliably, reproducibly, and over longer periods of time fulfils the three primary aims of clinical efficacy, continued motion, and few adjacent segment degenerative problems. Total disc replacement seems to be associated with a high rate of re-operations, and the potential problems that may occur with longer follow-up have not been addressed. Therefore, total disc replacements should be considered experimental procedures and should only be used in strict clinical trials.

Arthroplasty, Replacement↗

[The disc prosthesis: myths and facts].

The results of surgical treatment of degenerative low-back conditions by means of a fusion (spondylodesis) are in general less predictable than operative treatments for arthrosis of the (large) peripheral joints. Recently, new techniques of disc replacement have been developed as an alternative to traditional fusion operations. The most important theoretical advantage is the prevention of adjacent segment degeneration in the longer term. Because the disc prosthesis replaces the presumably painful intervertebral disc--just as an intercorporal fusion--the short-term results are expected to be comparable to ventral fusion. The results with a short follow-up period described in the literature are comparable to those published for spondylodesis. However, disc prosthesis requires a more extensive approach and therefore more serious complications are to be expected. In the longer term, prosthesis-related complications can be expected because these prostheses are used in young and active patients. Despite 15 years of small-scale experience in some European countries, there is a lack of reliable information about the middle and long-term performance of these prostheses in the peer-reviewed literature. Therefore, these implantations should be regarded as experimental procedures and should be confined to clinical trials in centres with sufficient experience in the operative treatment of degenerative low-back conditions as well as the necessary infrastructure to follow up these usually young patients in a scientifically responsible manner over a period of decades. These centres should also have the expertise necessary to adequately deal with the possible complications.

Humans↗

Severe erosion of lumbar vertebral body because of abdominal aortic false aneurysm: report of two cases.

STUDY DESIGN: Two cases of lumbar vertebral erosion resulting from abdominal aortic false aneurysm are reported. OBJECTIVE: To present an uncommon complication of aortic endoprosthesis causing spinal pathology. SUMMARY OF BACKGROUND DATA: Vertebral body pathologies usually are associated with fracture, osteoporotic collapse, tumor, spondylitis, or spondylodiscitis. Aortic abdominal aneurysm rarely has been reported as causing lytic lesions of the spine. METHODS: A retrospective case analysis was performed for two patients with an aorta bifurcation prosthesis and lytic lesions of the spine. False aneurysms were detected at the proximal junction of the prostheses. A biopsy of the affected vertebrae showed no infection or malignancy. Surgery was performed in both cases, and the prostheses were successfully revised. In one case, an anteroposterior spinal fusion was performed because of severe anterior bone loss. RESULTS: The back pain of both patients resolved completely after surgery. In one of the patients, an embolectomy in the right leg failed, and a below-the-knee amputation had to be performed. CONCLUSIONS: In patients with endovascular prostheses, false aneurysm should be considered when lytic lesions of vertebral bodies are differentially diagnosed because these patients can present with only spinal symptoms.

Aged↗

Letters.

Explore the source record for details and available documents.

Bone Transplantation↗

Some complications of common treatment schemes of thoracolumbar spine fractures can be predicted with magnetic resonance imaging: prospective study of 53 patients with 71 fractures.

STUDY DESIGN: Prospective cohort study. OBJECTIVES: To study the predictive value of magnetic resonance imaging (MRI) findings of thoracolumbar spine fractures concerning the radiologic and clinical outcome. SUMMARY OF BACKGROUND DATA: Disagreement about the proper treatment of thoracolumbar spine fractures is caused by insufficiency of conventional imaging techniques. Previous studies have shown that MRI is capable of distinguishing injury to all structures of the fractured spine and thus may help develop schemes with higher predictive power. METHODS: A total of 53 patients with 71 fractures were studied with MRI in a prospective fashion. A total of 24 patients with 39 fractures were treated conservatively and 29 patients with 32 fractures were treated operatively after a protocol concerning the treatment options. MRI scans were obtained within 1 week of injury and at the 2-year follow-up. Pain scores were obtained at the 2-year follow-up. Previously described MRI schemes concerning the trauma and post-trauma conditions were used. RESULTS AND CONCLUSIONS: An unfavorable outcome in the conservative group was related to the progression of kyphosis, which in most cases was predictable with the use of trauma MRI findings concerning the endplate comminution and vertebral body involvement. In the operatively treated group, recurrence of the kyphotic deformity was predictable by the lesion of the posterior longitudinal ligamentary complex together with endplate comminution and vertebral body involvement as seen on trauma MRI. The authors recommend the use of MRI to develop reliable prognostic criteria for these injuries.

Adolescent↗

Balloon vertebroplasty with calcium phosphate cement augmentation for direct restoration of traumatic thoracolumbar vertebral fractures.

STUDY DESIGN: A human cadaveric model was used to evaluate balloon vertebroplasty in traumatic vertebral fractures. OBJECTIVES: To assess the feasibility and safety of balloon vertebroplasty followed by calcium phosphate cement augmentation to prevent recurrent kyphosis. SUMMARY OF BACKGROUND DATA: Failure after short-segment pedicle-screw fixation for the treatment of vertebral fractures is probably caused by a redistribution of disc material through the fractured endplate into the vertebral body, causing a decrease in anterior column support. This lack of support can give rise to instrument breakage and recurrent kyphosis after removal of the instrumentation. Restoration of the endplate morphology could prevent these events. METHODS: Twenty-three traumatic fractures of thoracolumbar vertebrae were created. All fractures were distracted and fixated with short-segment pedicle screws and rods. Transpedicularly introduced inflatable bone tamps and subsequent injection of calcium phosphate cement were used to restore the endplates. Quantitative analyses of magnetic resonance images obtained at three time points were used to evaluate the morphology of the vertebral body and disc-space. After slicing all specimens, macroscopical examination was performed to detect leakage of cement or bone displacement in undesired directions. RESULTS: No technical problems were encountered during the study. The balloon vertebroplasty resulted in a significant (P = 0.0014) decrease of cranial endplate impression. No cement leakage or undesired bone displacement could be detected radiologically or macroscopically. CONCLUSIONS: The present study suggests that balloon vertebroplasty may be a safe and feasible procedure for the restoration of traumatic thoracolumbar vertebral fractures.

Aged↗

Classification of thoracic and lumbar spine fractures: problems of reproducibility. A study of 53 patients using CT and MRI.

Reproducibility of fracture classification systems in general has been a matter of controversy. The reproducibility of spinal fracture classifications has not been sufficiently studied. We studied the inter-observer and intra-observer reproducibility of the Magerl (AO) classification using radiograms, CTs and MRIs of 53 patients. We compared this classification with the older and simpler Denis classification. Five observers classified the fractures, first using the radiograms and CTs and, 6 weeks later, with radiograms and MRIs. Three of the observers repeated the readings after 3 months. Three observers also classified the fractures according to Denis. Agreement was measured using Cohen's kappa test. The type (A, B, C) classification of the AO system was fairly reproducible with CTs. With MRI this was only moderate. Group subclassification of the types yielded higher kappa values, corresponding to substantial agreement. The agreement was, in general, better with the Denis classification, but the variance was higher due to the difficulty of finding proper categories for some injury patterns. Although the AO classification allows proper registration of all kinds of injury, the reproducibility, especially at the type level, is problematic. Use of MRI and better definition of the distinctive properties of the three different types may enhance the reproducibility of the scheme.

Diagnosis, Differential↗

Bone tissue-engineered implants using human bone marrow stromal cells: effect of culture conditions and donor age.

At present, it is well known that populations of human bone marrow stromal cells (HBMSCs) can differentiate into osteoblasts and produce bone. However, the amount of cells with osteogenic potential that is ultimately obtained will still be dependent on both patient physiological status and culture system. In addition, to use a cell therapy approach in orthopedics, large cell numbers will be required and, as a result, knowledge of the factors affecting the growth kinetics of these cells is needed. In the present study we investigated the effect of dexamethasone stimulation on the in vivo osteogenic potential of HBMSCs. After a proliferation step, the cells were seeded and cultured on porous calcium phosphate scaffolds for 1 week, and then subcutaneously implanted in nude mice for 6 weeks, in order to evaluate their in vivo bone-forming ability. Furthermore, the effect of donor age on the proliferation rate of the cultures and their ability to induce in vivo bone formation was studied. In 67% of the assayed patients (8 of 12), the presence of dexamethasone in culture was not required to obtain in vivo bone tissue formation. However, in cultures without bone-forming ability or with a low degree of osteogenesis, dexamethasone increased the bone-forming capacity of the cells. During cellular proliferation, a significant age-related decrease was observed in the growth rate of cells from donors older than 50 years as compared with younger donors. With regard to the effect of donor age on in vivo bone formation, HBMSCs from several donors in all age groups proved to possess in vivo osteogenic potential, indicating that the use of cell therapy in the repair of bone defects can be applicable irrespective of patient age. However, the increase in donor age significantly decreased the frequency of cases in which bone formation was observed.

Age Factors↗

Traumatic lumbosacral dislocation: case report.

STUDY DESIGN: A case report of a bilateral lumbosacral dislocation without a fracture is presented. OBJECTIVE: To report the diagnosis and treatment of a traumatic lumbosacral dislocation. SUMMARY OF BACKGROUND DATA: Lumbosacral dislocations without fractures are rare injuries, with only four cases reported in literature. The recommended treatment consists of an anterior lumbar interbody fusion after posterior reduction with pedicle screw instrumentation. METHODS: The 1-year follow-up evaluation of a 17-year-old male with a traumatic lumbosacral dislocation, diagnosed with computed tomography and magnetic resonance imaging, and treated with a posterior lumbar interbody fusion procedure combined with a posterolateral fusion is reported. RESULTS: At 1 year after surgery the patient is asymptomatic and has resumed his heavy manual work. Radiologic evidence of interbody fusion is present. CONCLUSIONS: Lumbosacral dislocations are rare injuries. The authors demonstrate the feasibility of a posterior lumbar interbody fusion procedure in combination with posterolateral instrumentation and fusion.

Accidents, Occupational↗

MRI findings of thoracolumbar spine fractures: a categorisation based on MRI examinations of 100 fractures.

OBJECTIVE: To define the state of different structures of the fractured thoracolumbar spine which may play a role in the immediate and long-term mechanical stability on MR images and to investigate the relationship of these findings with the AO classification of spinal injuries. DESIGN: The state of the anterior longitudinal ligament, posterior longitudinal ligament, posterior ligamentous complex, cranial and caudal endplates, cranial and caudal discs and the vertebral body were defined using clinical, experimental and radiological data. The state of these structures was reported for each fracture on the MRI examinations and the different MRI features appropriate for different fracture classes were defined. PATIENTS: MRI examinations of 70 patients with 100 fractures of the thoracolumbar spine were used for this study. RESULTS: Wide variations were seen in the state of the structures studied. We could not find a definite pattern to relate these findings with the AO classification scheme. CONCLUSIONS: MR findings should be integrated into future classification schemes of thoracolumbar spine fractures. This would enable specific data about the structures involved in the stability of the spine to be acquired. Prospective studies using the criteria developed in this study may help resolve some of the controversies concerning the diagnosis and prognosis of these injuries as well as the development of new classification systems.

Humans↗

Correlation of MR images of disc injuries with anatomic sections in experimental thoracolumbar spine fractures.

This cadaver study evaluated the value of MR images for detection of acute intervertebral disc damage associated with fractures of the thoracolumbar spine. Damage to the intervertebral disc may be a major contributor to chronic instability in non-operative treatment or failure of fixation and recurrence of deformity in posterior fixation methods. MR imaging can help us to understand the injury patterns and their prognostic significance. However, before we can justify the use of MRI in clinical cases, determination of MRI's ability to detect acute injury to the disc is necessary. Ten fresh cadaver specimens were used for this study. After obtaining radiograms and MR images, injuries were created with a weight-dropping apparatus using a variety of weights and compression angles. Post-injury radiograms and MR images were taken and the specimens were frozen at -20 degrees C. Slides of these specimens obtained with cryosection techniques were compared with MR images for evaluation of the damage to different parts of the discs. A total of 20 fractures were observed on cryosections. In 12 of the discs adjacent to fractured vertebral bodies, macroscopic damage was seen on the sections. These were all detected on the corresponding MR images. The study showed that MRI is able to detect acute, macroscopic injury to the intervertebral disc. It is therefore justified to use MR for the study of acute disc damage associated with thoracolumbar fractures.

Aged↗

The prevention of peridural adhesions. A comparative long-term histomorphometric study using a biodegradable barrier and a fat graft.

We studied peridural fibrosis in 16 dogs after laminectomies at the L2, L4 and L6 levels. They received either a free fat graft, a biodegradable mechanical barrier (polyethylene oxide (PEO)/polybutylene terephthalate (PBT) copolymer), or no treatment. The animals were killed after 4, 12, 26 and 52 weeks. Histomorphometry showed extensive and consistent peridural fibrosis in control and PEO/PBT groups. Fat grafts produced significantly less fibrous tissue, but the presence of the fat graft in the bony defect prevented closure. Degradation of the PEO/PBT barrier resulted in the formation of more fibrous tissue. We conclude that up to one year a free fat graft is effective in reducing the amount of peridural scarring.

Adipose Tissue↗

Changes in the disc space after fractures of the thoracolumbar spine.

We have studied the intervertebral discs adjacent to fractured vertebral bodies using MRI in 63 patients at a minimum of 18 months after injury. There were 75 thoracolumbar fractures of which 26 were treated conservatively and 37 by posterior reduction and fusion with an AO internal fixator. We identified six different types of disc using criteria based on the morphology and the intensity of the MRI signal. The inter- and intraobserver variability of this system was good. Most of the discs showed predominantly morphological changes with no variation in signal intensity. Some disc types were associated with progressive kyphosis in patients treated conservatively. In those managed by operation, recurrent kyphosis appeared to result from creeping of the disc in the central depression of the bony endplate rather than from disc degeneration. Changes in the disc space after posterior fixation should not be seen as a form of chronic instability but as a redistribution of the disc tissue in the changed morphology of the space after fractures of the endplate.

Adolescent↗

Recurrent kyphosis after posterior stabilization of thoracolumbar fractures. 24 cases treated with a Dick internal fixator followed for 1.5-4 years.

24 patients with Th12-L1 fractures treated with a Dick internal fixator were analyzed to assess predictors of poor outcome. 4 patients had fixation without bone transplantation, 20 patients had a posterior fusion, and 12 of them had additional transpedicular spongioplasty. There were fractures of the transpedicular screws in 4 and screw migration in 2 cases. The increase in the local kyphosis angle was greater than the increase in the anterior compression angle and this did not correlate with spongioplasty or fusion. Fixation failure was in all cases related to a disproportionate increase in the local kyphosis angle. There was no difference between the patients with transpedicular spongioplasty and posterior fusion and the other patients with respect to results and complications. Bony collapse was not the major cause of failure and consequently there was no measureable contribution of transpedicular spongioplasty. We found that the Dick internal fixator for unstable fractures was associated with a higher complication rate than earlier reported.

Adolescent↗

Effect of mental state on mortality after hemiarthroplasty for fracture of the femoral neck. A retrospective study of 543 patients.

OBJECTIVE: To assess mortality and functional results of Thompson's hemiarthroplasty for fractured neck of femur in patients with and without senile dementia. DESIGN: Retrospective study. SETTING: District hospital. SUBJECT: 543 Unselected patients who had intracapsular fractures of the femoral neck treated by hemiarthroplasty between 1979 and 1988. MAIN OUTCOME MEASURES: Mortality and functional results during a median follow up period of 14.9 months (range 0.0-111) for patients with senile dementia and 27.4 months (range 0.1-131) for patients who were not demented. RESULTS: 156 of 215 demented patients (73%) died during the follow up period compared with 169 of 328 of those who were not demented (52%). Of the 109 patients with dementia who were mobile before operation only 59 were mobile after operation (54%), compared with 199 of the 215 patients (93%) who were not demented (p < 0.001). Senile dementia seemed to be the only coexisting condition that had a significant effect on mortality. CONCLUSION: Hemiarthroplasty is probably too major an operation with which to treat fractures of the femoral neck in demented patients.

Aged↗