Instrumented posterolateral lumbar fusion using coralline hydroxyapatite with or without demineralized bone matrix, as an adjunct to autologous bone.
Instrumented posterolateral lumbar fusion using coralline hydroxyapatite with or without demineralized bone matrix, as an adjunct to autologous bone.
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DOI：
10.1016/s1529-9430(01)00011-0
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发表时间：
2001-03-01
期刊：
影响因子：
--
通讯作者：
Klezl, Z
中科院分区：
文献类型：
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作者：
Thalgott, J S;Giuffre, J M;Klezl, Z
背景：自体后外侧融合结合或不结合内固定都有良好的结果。然而，难以融合的患者，如吸烟者、骨质和/或骨量较差的老年患者或既往接受过后路手术的患者，融合率可能会稍低。目的：在长期随访的人类临床模型中，确定含或不含脱矿骨基质的珊瑚羟基磷灰石作为骨移植扩展剂的疗效。一个回顾性系列的40例患者接受了自体后外侧腰椎融合术，用珊瑚羟基磷灰石加或不加脱钙骨matrix.Patient样本：长期的临床和影像学随访进行了检查，40例患者只接受了内固定后外侧融合术。接受前路腰椎椎体间融合术（ALIF）的患者不被视为sample.METHODS的一部分：所有患者均接受了成功的经椎弓根固定与自体后外侧腰椎融合术。在每个节段使用15 cc Pro Osteon 500珊瑚羟基磷灰石（Interpore Cross International，Irvine，CA）。70%的患者额外使用了10 cc Grafton脱矿骨基质凝胶（Osteotech，伊顿镇，NJ）。疼痛和功能改善良好，但有一定的年龄依赖性，并与合并症的数量相关。使用Grafton DBM凝胶的患者融合率较低，为89.3%。结论：根据这项小型回顾性研究，珊瑚羟基磷灰石是一种有效的植骨延长器，可作为自体骨的辅助材料，用于腰椎后外侧融合。
BACKGROUND CONTEXT: Autogenous posterolateral fusion with and without instrumentation has been reported with good results. However, difficult-to-fuse patients, such as smokers, elderly patients with poor bone quality and/or quantity, or patients with prior posterior surgeries, may have somewhat lower fusion rates.PURPOSE: To determine the efficacy of coralline hydroxyapatite with or without demineralized bone matrix as a bone graft extender in a human clinical model with long-term follow-up.STUDY DESIGN/SETTING: A retrospective series of 40 patients undergoing instrumented autogenous posterolateral lumbar fusion augmented with coralline hydroxyapatite with or without demineralized bone matrix.PATIENT SAMPLE: Long-term clinical and radiographic follow-up were examined for 40 patients who underwent an instrumented posterolateral fusion only. Patients undergoing anterior lumbar interbody fusion (ALIF) procedures were not considered part of the sample.METHODS: All patients underwent successful transpedicular fixation with autogenous posterolateral lumbar fusion. Fifteen cc of Pro Osteon 500 coralline hydroxyapatite (Interpore Cross International, Irvine, CA) was used at each level. An additional 10 cc of Grafton demineralized bone matrix gel (Osteotech, Eatontown, NJ) was used in 70% of these patients.RESULTS: An overall fusion rate of 92.5% was achieved. Pain and function improvement were good but somewhat age dependent and correlated with the number of comorbidities. Patients with Grafton DBM gel had a lower fusion rate of 89.3%.CONCLUSIONS: Based on this small retrospective review, coralline hydroxyapatite is an effective bone graft extender in difficult-to-fuse patients as an adjunct to autologous bone for posterolateral fusion of the lumbar spine when combined with rigid instrumentation.