Allograft Versus Autograft in Instrumented Posterolateral Lumbar Spinal Fusion

Gibson, Suzy; McLeod, Ian; Wardlaw, Douglas; Urbaniak, S. J.

doi:10.1097/00007632-200208010-00002

Cited by 104 publications

(68 citation statements)

References 30 publications

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“…Before insertion, the amount of graft was quantified by weighing. The properties of the femoral head are very similar to those described by Gibson et al [15]. Battery life in the stimulator was at least 6 months and the stimulator battery (not the electrodes) was removed with local anaesthesia within 6 months to 1 year after the primary operation.…”

Section: Patient Populationsupporting

confidence: 56%

Fusion mass bone quality after uninstrumented spinal fusion in older patients

et al. 2010

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Older people are at increased risk of non-union after spinal fusion, but little is known about the factors determining the quality of the fusion mass in this patient group. The aim of this study was to investigate fusion mass bone quality after uninstrumented spinal fusion and to evaluate if it could be improved by additional direct current (DC) electrical stimulation. A multicenter RCT compared 40 and 100 lA DC stimulation with a control group of uninstrumented posterolateral fusion in patients older than 60 years. This report comprised 80 patients who underwent DEXA scanning at the 1 year follow-up. The study population consisted of 29 men with a mean age of 72 years (range 62-85) and 51 women with a mean age of 72 years (range 61-84). All patients underwent DEXA scanning of their fusion mass. Fusion rate was assessed at the 2 year follow-up using thin slice CT scanning. DC electrical stimulation did not improve fusion mass bone quality. Smokers had lower fusion mass BMD (0.447 g/cm 2 ) compared to non-smokers (0.517 g/cm 2 ) (P = 0.086). Women had lower fusion mass BMD (0.460 g/ cm 2 ) compared to men (0.552 g/cm 2 ) (P = 0.057). Using linear regression, fusion mass bone quality, measured as BMD, was significantly influenced by gender, age of the patient, bone density of the remaining part of the lumbar spine, amount of bone graft applied and smoking. Fusion rates in this cohort was 34% in the control group and 33 and 43% in the 40 and 100 lA groups, respectively (not significant). Patients classified as fused after 2 years had significant higher fusion mass BMD at 1 year (0.592 vs. 0.466 g/cm 2 , P = 0.0001). Fusion mass bone quality in older patients depends on several factors. Special attention should be given to women with manifest or borderline osteoporosis. Furthermore, bone graft materials with inductive potential might be considered for this patient population.

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Section: Patient Populationsupporting

confidence: 56%

Fusion mass bone quality after uninstrumented spinal fusion in older patients

et al. 2010

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“…No artigo de Löfgren et al, a casuísti-ca de 43 pacientes é dividida em três grupos (osso autólogo, homólogo e heterólogo), o que aumenta a margem de erro estatística (8) . Já no artigo de Gibson et al, baseado em casos de 2002, artrodese da coluna lombar, foram utilizadas cabeças femorais (osso fresco congelado), material com aparente maior capacidade osteoindutora, com resultados mais convincentes (69 casos, seguimento de seis anos e desenho objetivo de estudo, com análise de poucas variáveis) (7) . Portanto, caso outros trabalhos reproduzam seus resultados, podemos dizer que há equivalência entre os enxertos homólogo e autólogo para esse tipo de procedimento.…”

Section: Discussionunclassified

“…Allograft versus autograft in instrumented posterolateral lumbar spinal fusion: a randomized Gibson et al (7) control trial.…”

mentioning

confidence: 99%

“…O substituto ósseo mostrou-se equivalente ao enxerto autólogo em 19 estudos (4)(5)(6)(7)(8)(9)(10)(11)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) e inferior em três (12,(24)(25) .…”

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“…Dos 22 artigos, 19 fizeram referência a cirurgias da coluna vertebral (4)(5)(6)(7)(8)(9)(10)(14)(15)(17)(18)(19)(20)(21)(22)(23)(24)(25) e três a cirurgias do esqueleto apendicular (11,13,16) , fazendo com que todos os 22 trabalhos fossem considerados em conjunto, sem distinção entre os diferentes tipos de esqueleto.…”

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