In vitro osteoblast-like cell metabolism in spondylodesis-a tool that may predict fusion capacityA prospective study in 50 patients with a 1-year follow-up

Laursen, Malene; Christensen, Finn Kjær; Lind, Martin; Hansen, Ebbe Stender; Høy, Kristian; Gelineck, John; Bünger, Cody

doi:10.1080/00016470310018289

Cited by 4 publications

(2 citation statements)

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“…One randomized study has shown that it gives similar outcomes compared to autograft in instrumented posterolateral fusion (Gibson et al 2002); however, most surgeons still believe that autograft has superior qualities (An et al 1995, Sandhu et al 1999, Ehrler and Vaccaro 2000). The use of allografts in the older patient population may be problematic due to reduced fusion potential (Lohmann et al 2001, Laursen et al 2003). One long-term study in an elderly population has shown significantly better outcomes in patients in which a solid fusion was obtained compared to those without (Kornblum et al 2004).…”

Section: Introductionmentioning

confidence: 99%

Impact of instrumentation in lumbar spinal fusion in elderly patients

et al. 2009

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Background and purpose An increasing number of lumbar fusions are performed using allograft to avoid donor-site pain. In elderly patients, fusion potential is reduced and the patient may need supplementary stability to achieve a solid fusion if allograft is used. We investigated the effect of instrumentation in lumbar spinal fusion performed with fresh frozen allograft in elderly patients.Methods 94 patients, mean age 70 (60–88) years, who underwent posterolateral spinal fusion either non-instrumented (51 patients) or instrumented (43 patients) were followed for 2–7 years. Functional outcome was assessed with the Dallas pain questionnaire (DPQ), the low back pain rating scale pain index (LBPRS), and SF-36. Fusion was assessed using plain radiographs.Results Instrumented patients had statistically significantly better outcome scores in 6 of 7 parameters. Fusion rate was higher in the instrumented group (81% vs. 68%, p = 0.1). Solid fusion was associated with a better functional outcome at follow-up (significant in 2 of 7 parameters). 15 patients (6 in the non-instrumented group and 9 in the instrumented group) had repeated lumbar surgery after their initial fusion procedure. Functional outcome was poorer in the group with additional spine surgeries (significant in 4 of 7 parameters).Interpretation Superior outcomes after lumbar spinal fusion in elderly patients can be achieved by use of instrumentation in selected patients. Outcome was better in patients in which a solid fusion was obtained. Instrumentation was associated with a larger number of additional surgeries, which resulted in a lesser degree of improvement. Instrumentation should not be discarded just because of the age of the patient.

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Section: Introductionmentioning

confidence: 99%

Impact of instrumentation in lumbar spinal fusion in elderly patients

et al. 2009

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“…However, a reduced fusion potential is one of the problems in the older patient population. [15][16][17][18] This, combined with use of allograft with lesser or no osteoinductive potential, calls for methods that can increase fusion rates; direct current (DC) electrical stimulation is one of these methods.…”

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confidence: 99%