Autograft containment in posterolateral spine fusion
Autograft containment in posterolateral spine fusion
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DOI：
10.1016/j.spinee.2007.04.017
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发表时间：
2008-07-01
期刊：
影响因子：
4.5
通讯作者：
Cooley, Brian C.
中科院分区：
文献类型：
--
作者：
Rao, Raj D.;Bagaria, Vaibhav;Cooley, Brian C.
背景：腰椎横突间融合术的假关节发生率仍然很高。椎旁肌肉组织对正在发育的融合块的压迫和移位可能是一个促成因素。生物防护装置已在临床上用于颅骨和下颌骨，以引导骨再生。在后外侧腰椎融合术中，机械装置在容纳移植物材料中的作用尚不清楚。目的：确定使用生物可吸收移植物容纳装置进行腰椎横突间融合术的益处，并通过宿主组织反应的组织学分析来评估该植入物的生物相容性。使用兔横突间脊柱融合模型评价生物可吸收移植物容纳植入物。研究组和对照组进行了比较方面的速度，体积和质量的融合，以及宿主组织反应的移植物和implant.METHODS：14成年雄性新西兰白色兔进行了双边后外侧intertransmarts脊柱关节融合术在L3-L4。对照组（n=7）仅接受自体移植物，研究组接受放置在由LactoSorb片（LactoSorb; Biomet Orthopedics Inc.，Warsaw，IN）.在6周时收获脊柱并成像。使用X线片和计算机断层扫描（CT）图像计算融合块的比率、面积和体积。将切片固定并用苏木精-伊红和马洛里三色染色，用于融合和宿主组织反应的组织学分析。采用Mann-Whitney非参数统计检验进行影像学和CT定性评估。使用Student t检验分析CT体积定量。生物防护组和对照组之间的p值为0.05）。与对照组（2.12 +/- 0.15 cc）相比，生物防护组融合体积显著增加（平均值+/-标准误;左+右融合侧总体积=2.88 +/- 0.30 cc）（p
BACKGROUND CONTEXT: Pseudoarthrosis rates in lumbar intertransverse fusion remain high. Compression and displacement of the developing fusion mass by the paraspinal musculature may be a contributory factor. Biocontainment devices have been clinically used in the skull and mandible to guide bone regeneration. The role of a mechanical device in containing graft material in the developing posterolateral lumbar spine fusion is unclear.PURPOSE: To determine the benefits of using a bioabsorbable graft-containment device for lumbar intertransverse fusion, and to evaluate the biocompatibility of this implant by histological analysis of the host tissue reaction.STUDY DESIGN: A rabbit intertransverse spine fusion model was used to evaluate a bioabsorbable graft-containment implant. Study and control groups were compared with regard to the rate, volume, and quality of fusion, as well as host tissue reaction to the graft and implant.METHODS: Fourteen adult male New Zealand White rabbits underwent bilateral posterolateral intertransverse spine arthrodesis at L3-L4. The control group (n=7) received autograft alone, and the study group received autografts placed in open meshed hemicylinders fashioned from LactoSorb sheets (LactoSorb; Biomet Orthopedics Inc., Warsaw, IN). Spines were harvested at 6 weeks and imaged. Radiographs and computed tomography (CT) images were used to calculate the rate, area, and volume of fusion mass. Sections were fixed and stained with hematoxylin-eosin and Mallory trichrome for histological analysis of fusion and host tissue response. The Mann-Whitney non-parametric statistical test was used for the radiographic and CT qualitative assessments. The CT volume quantitation was analyzed using the Student t test. A p value of .05) between the biocontainment and control groups. The volume of fusion revealed a significant increase with biocontainment (mean +/- standard error; total left+right fusion sides=2.88 +/- 0.30 cc) compared with controls (2.12 +/- 0.15 cc) (p