Instrumented Spondylodesis in Degenerative Spondylolisthesis With Bioactive Glass and Autologous Bone

Abstract

A prospective long-term follow-up study of bioactive glass (BAG)-S53P4 and autogenous bone (AB) used as bone graft substitutes for posterolateral spondylodesis in treatment of degenerative spondylolisthesis during 1996 to 1998 was conducted. The surgical procedure was a standardized instrumented posterolateral fusion that used USS/VAS. BAG was implanted on the left side of the fusion bed and AB on the right side. The operative outcome was evaluated on x-rays and computed tomography scans, and a clinical examination was also performed. Seventeen patients (12 women, 5 men) participated in the 11-year follow-up. The mean Oswestry Disability Index score at the follow-up was 21 (range 0 to 52), compared with 49 (range 32 to 64) at the preoperative time. A solid bony fusion was seen on computed tomography scans on the AB side in all patients and on the BAG side in 12 patients. The fusion rate of all fusion sites (n=41) for BAG as a bone substitute was 88% at the L4/5 level and 88% at the L5/S1 level. The use of BAG as a bone graft extender can be considered as a good alternative in spinal surgery in the future.

Reprint of: Review of bioactive glass: From Hench to hybrids

“…5). After 11 years, the fusion rate for the glass was 88% compared to 100% for autograft [38]. Similar results were seen for treatment of osteomyelitis, where the bone quality of the vertebrae is reduced due to bacterial infection [39].…”

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

“…The antibacterial properties of the glass are related to a high pH and an osmotic pressure in the vicinity of the glass, caused by the dissolution process at the glass surface [26]. BAG S53P4 has been studied clinically in randomised prospective trials in bone tumour [27,28], trauma [29] and spine surgery [30,31]. Due to its antibacterial properties is has also been used in the treatment of severe chronic osteomyelitis, mastoiditis, spine infections and frontal sinus infections [21,[32][33][34][35][36][37][38].…”

Bioglass and Bioactive Glasses and Their Impact on Healthcare

“…S53P4 granules of 1–2 mm were compared to autograft and held in position between vertebrae by compression of the vertebrae using metal screws. After 11 years, the fusion rate for the glass was 88% compared to 100% for autograft.…”