Bone morphogenetic proteins in anterior lumbar interbody fusion: old techniques and new technologies

Burkus, J. Kenneth

doi:10.3171/spi.2004.1.3.0254

Cited by 50 publications

(24 citation statements)

References 20 publications

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“…In terms of interbody fusion technique, these doses were considerably lower than the 12-18 mg per level used in 3 different clinical trials in which rhBMP-2 was used with anterior lumbar interbody fusion. 11 Similarly, much less rhBMP-2 was used posteriorly than the 10-40 mg per level reported by other groups performing instrumented posterolateral fusions. 8,22 Given the successful fusion achieved in our series with much lower dosing of rhBMP-2 per level, further studies are probably warranted to determine the minimum effective dose of rhBMP-2 necessary to achieve a successful arthrodesis.…”

Section: Discussionmentioning

confidence: 99%

Mid-term to long-term clinical and functional outcomes of minimally invasive correction and fusion for adults with scoliosis

Anand¹,

Rosemann²,

Khalsa

et al. 2010

FOC

208

136

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Object The goal of this study was to assess the operative outcomes of adult patients with scoliosis who were treated surgically with minimally invasive correction and fusion. Methods This was a retrospective study of 28 consecutive patients who underwent minimally invasive correction and fusion over 3 or more levels for adult scoliosis. Hospital and office charts were reviewed for clinical data. Functional outcome data were collected at each visit and at the last follow-up through self-administered questionnaires. All radiological measurements were obtained using standardized computer measuring tools. Results The mean age of the patients in the study was 67.7 years (range 22–81 years), with a mean follow-up time of 22 months (range 13–37 months). Estimated blood loss for anterior procedures (transpsoas discectomy and interbody fusions) was 241 ml (range 20–2000 ml). Estimated blood loss for posterior procedures, including L5–S1 transsacral interbody fusion (and in some cases L4–5 and L5–S1 transsacral interbody fusion) and percutaneous screw fixation, was 231 ml (range 50–400 ml). The mean operating time, which was recorded from incision time to closure, was 232 minutes (range 104–448 minutes) for the anterior procedures, and for posterior procedures it was 248 minutes (range 141–370 minutes). The mean length of hospital stay was 10 days (range 3–20 days). The preoperative Cobb angle was 22° (range 15–62°), which corrected to 7° (range 0–22°). All patients maintained correction of their deformity and were noted to have solid arthrodesis on plain radiographs. This was further confirmed on CT scans in 21 patients. The mean preoperative visual analog scale and treatment intensity scale scores were 7.05 and 53.5; postoperatively these were 3.03 and 25.88, respectively. The mean preoperative 36-Item Short Form Health Survey and Oswestry Disability Index scores were 55.73 and 39.13; postoperatively they were 61.50 and 7, respectively. In terms of major complications, 2 patients had quadriceps palsies from which they recovered within 6 months, 1 sustained a retrocapsular renal hematoma, and 1 patient had an unrelated cerebellar hemorrhage. Conclusions Minimally invasive surgical correction of adult scoliosis results in mid- to long-term outcomes similar to traditional surgical approaches. Whereas operating times are comparable to those achieved with open approaches, blood loss and morbidity appear to be significantly lower in patients undergoing minimally invasive deformity correction. This approach may be particularly useful in the elderly.

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Section: Discussionmentioning

confidence: 99%

Mid-term to long-term clinical and functional outcomes of minimally invasive correction and fusion for adults with scoliosis

Anand¹,

Rosemann²,

Khalsa

et al. 2010

FOC

208

136

View full text Add to dashboard Cite

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“…Lumbar interbody fusion is one approach of choice increasingly employed by many spine surgeons today [2,3] and [4]. In classical lumbar interbody fusion, mechanical (metallic) cage devices or spacers packed with autogenous bone are implanted in a recipient bone bed prepared between adjacent vertebral bodies [3].…”

Section: Introductionmentioning

confidence: 99%

Biological performance of a polycaprolactone-based scaffold used as fusion cage device in a large animal model of spinal reconstructive surgery

et al. 2009

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“…Recombinant human BMP has been widely used in the setting of anterior interbody fusions, and it has been shown to improve radiographic fusion and clinical outcome. 5,6 Although cases of vertebral osteolysis have been associated with the use of rhBMP, 20,22 it remains a powerful tool in modern spine surgery and promotes fusion rates comparable to autografts without the risks associated with graft harvesting. [5][6][7]9,28 Following placement of rhBMP, the 25-mm gap following the T11-12 discectomy and the PVCSO was closed with serial compression through the domino connectors to achieve spinal column shortening.…”

Section: Casementioning

confidence: 99%

Posterior vertebral column subtraction osteotomy: a novel surgical approach for the treatment of multiple recurrences of tethered cord syndrome

Hsieh

Ondra

Grande

et al. 2009

SPI

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Recurrent tethered cord syndrome (TCS) has been reported to develop in 5–50% of patients following initial spinal cord detethering operations. Surgery for multiple recurrences of TCS can be difficult and is associated with significant complications. Using a cadaveric tethered spinal cord model, Grande and colleagues demonstrated that shortening of the vertebral column by performing a 15–25-mm thoracolumbar osteotomy significantly reduced spinal cord, lumbosacral nerve root, and terminal filum tension. Based on this cadaveric study, spinal column shortening by a thoracolumbar subtraction osteotomy may be a viable alternative treatment to traditional surgical detethering for multiple recurrences of TCS. In this article, the authors describe the use of posterior vertebral column subtraction osteotomy (PVCSO) for the treatment of 2 patients with multiple recurrences of TCS. Vertebral column resection osteotomy has been widely used in the surgical correction of fixed spinal deformity. The PVCSO is a novel surgical treatment for multiple recurrences of TCS. In such cases, PVCSO may allow surgeons to avoid neural injury by obviating the need for dissection through previously operated sites and may reduce complications related to CSF leakage. The novel use of PVCSO for recurrent TCS is discussed in this report, including surgical considerations and techniques in performing PVCSO.

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Bone morphogenetic proteins in anterior lumbar interbody fusion: old techniques and new technologies

Cited by 50 publications

References 20 publications

Mid-term to long-term clinical and functional outcomes of minimally invasive correction and fusion for adults with scoliosis

Mid-term to long-term clinical and functional outcomes of minimally invasive correction and fusion for adults with scoliosis

Biological performance of a polycaprolactone-based scaffold used as fusion cage device in a large animal model of spinal reconstructive surgery

Posterior vertebral column subtraction osteotomy: a novel surgical approach for the treatment of multiple recurrences of tethered cord syndrome

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