The effect of equine-derived bone protein extract (Colloss-E) in the treatment of cavitary bone defects: an experimental study.

OBJECTIVE: Bone protein extract (BPE) usually requires a carrier or a scaffold for implantation. We aimed to compare the effect of equine-derived BPE, an osteoinductive agent composed of a high amount of type-I collagen and other bone proteins (Colloss-E), with that of human demineralized bone matrix (DBM) for treating cavitary bone defects not requiring scaffold use. METHODS: Rabbit distal femoral condyle was used as a stable cavitary bone defect model. Bone defects of 6-mm diameter and 10-12-mm depth were created in the femoral condyles. Rabbits were assigned into the equine-derived BPE (BPE), human-derived DBM (DBM), and control (C) groups. Approximately 20 mg of BPE was implanted into the defect in the equine-derived BPE group (n=6), whereas 0.3 cc of DBM was implanted in the DBM group (n=6). Defects were left empty in the C group (n=6). The defect area was histologically examined after 6 weeks. RESULTS: There were no instances of macroscopic defect collapse or failure. Histopathological examination revealed that the BPE group had better scores (statistically significant) than both the other groups in terms of quality of union. The BPE group also had higher scores than the DBM group in terms of graft incorporation and new-bone formation. CONCLUSION: The current study revealed results consistent with those of the previous studies concerning BPEs. Equine-derived BPE was found to be successful for treating cavitary bone defects not requiring scaffold use.

Alcohol neurolysis for persistent pain caused by superior cluneal nerves injury after iliac crest bone graft harvesting in orthopedic surgery: report of four cases and review of the literature.

STUDY DESIGN: Harvesting of autologous bone graft from the posterior iliac crest for lumbar spinal fusions is a frequently performed procedure in orthopedic surgery. The most common complication associated with this procedure is an alteration in sensation over the donor site manifested as chronic pain, hyperesthesia, dysesthesia, or diminished sensitivity resulting from superior cluneal nerve (SCN) injury. OBJECTIVE: To predict the effectiveness of alcohol neurolysis in the treatment of persistent pain caused by the entrapment of superior cluneal nerves. SUMMARY AND BACKGROUND DATA: The subjects of this study were patients with intractable pain in donor area after conventional treatments using a transverse incision, which is parallel to posterior iliac crest. The study group was composed of four patients who underwent surgery in a 1-year period and experienced chronic pain resulting from superior cluneal nerve injury. METHODS: No reports describing alcohol neurolysis of the superior cluneal nerve exist in the relevant literature. All four patients in this study were treated with alcohol neurolysis of the superior cluneal nerves. RESULTS: The study patients were observed up to 4 years, and none of them reported any problems. CONCLUSIONS: The authors suggest that conventional treatments be limited to a 2-month period, and that alcohol neurolysis be applied as soon as possible to prevent lengthy pain experiences.