Maturation of the Posterolateral Spinal Fusion and Its Effect on Load-Sharing of Spinal Instrumentation

Kanayama, Masahiro; Cunningham, Bryan W.; Weis, James C.; Parker, Larry M.; Kaneda, Kiyoshi; McAfee, Paul C.

doi:10.2106/00004623-199711000-00013

Cited by 64 publications

(39 citation statements)

References 21 publications

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“…Therefore, relatively more shear forces than compressive ones may act upon the graft. The largest part of the load is probably taken up by the device, but the load carried by the healing graft increases as it stiffens with time (Kanayama et al 1997). …”

Section: Discussionmentioning

confidence: 99%

Incomplete incorporation of morselized and impacted autologous bone graft: A histological study in 4 intracorporally grafted lumbar fractures

Tägil

Johnsson

Strömqvist

et al. 1999

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

Incomplete incorporation of morselized and impacted autologous bone graft: A histological study in 4 intracorporally grafted lumbar fractures

Tägil

Johnsson

Strömqvist

et al. 1999

Acta Orthopaedica Scandinavica

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“…1 Structural femoral allograft bone functions well for most patients, reducing donor site morbidity compared to structural autograft, and allowing sufficient volume to reconstruct as many spinal levels as are needed. [2][3][4][5][6][7][8] In addition to its mechanical function as an interbody spacer, allograft bone functions as biological scaffolding with osteoconductive properties, incorporating with host bone at the graft ends. Following implantation, the process of graft resorption and vascularization begins at the ends of the allograft, along with ongrowth of host bone onto the exterior surfaces of the graft.…”

mentioning

confidence: 99%

“…[5][6][7] Loads on the lumbar discs during quasi-static lifting of 195 N reach 3,400 N. 6 While supplemental spinal fixation provides some degree of load sharing, the mechanical requirements of lumbar spine interbody allograft are clearly substantial. 8 Fractures of structural allograft bone following cervical, thoracic, and lumbar spine fusions have been reported. [9][10][11][12][13][14] Failure of structural allograft may result in collapse of the disc space with an increased risk of pseudarthrosis or malunion, resulting in a less satisfactory clinical outcome and in some cases a need for revision surgery.…”

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confidence: 99%

Relationship of donor variables and graft dimension on biomechanical performance of femoral ring allograft

Hart

Daniels

Bahney

et al. 2011

Journal Orthopaedic Research

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Structural femoral ring allograft is commonly used in interbody spinal arthrodesis. Fractures of implanted femoral ring allograft have been reported. Data to guide donor screening and tissue processing by allograft tissue banks for factors that affect graft strength are incomplete. Fresh frozen human femora from 34 cadaveric donors were sectioned into ten 20-mm thick specimens. Bone mineral density (BMD), donor age, and graft dimensions were recorded for each specimen. Three hundred twenty-seven specimens were tested in quasi-static axial compression. Linear regression models compared load to failure with BMD, sex-specific donor age, minimum/maximum cortical wall thickness, and minimum/maximum outer ring diameter. Correlations between minimum and maximum cortical wall thickness and load to failure were significant (r ¼ 0.73, p < 0.001 and r ¼ 0.74, p < 0.001, respectively). BMD showed a weaker negative correlation with load to failure (r ¼ À0.11, p ¼ 0.05). Correlations between load to failure and minimum and maximum outer ring diameter and age (r ¼ 0.06, p ¼ 0.31) were not significant. We found that the minimum and maximum cortical wall thicknesses of femoral ring allograft are strongly correlated with the axial compressive load to failure of the graft. Other tested parameters did not prove to be effective predictors of resistance to axial loading. ß

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“…In addition, a condition without grafting was included to account for previously described spontaneous bone formation after decortication. 17,18 …”

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confidence: 99%

Relevance of bone graft viability in a goat transverse process model

Kruyt

Delawi

Habibović

et al. 2008

Journal Orthopaedic Research

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Little is known about the mechanism by which autologous bone grafts are so successful. The relevance of viable osteogenic cells, which is a prominent difference between autologous bone graft and conventional alternatives, is especially controversial. With the emergence of bone tissue engineering, knowledge of the exact role of these cells has become crucial. The most obvious question to answer is whether viability of the graft has an effect on bone formation. In the current study, we investigated this effect of bone graft viability in a transverse process model that represents the initial bone formation in posterolateral spinal fusion. Eight goats received viable and devitalized autologous bone grafts in chambers mounted on the decorticated lumbar transverse processes. In addition, five goats received empty chambers. Histology and histomorphometry were performed after a 12-week implantation, and the dynamics of bone formation was monitored by sequential fluorochrome labeling. An obvious qualitative effect of viability was demonstrated by the presence of early onset osteogenesis distant from the transverse process bone in the viable grafts only. Quantitative analysis indicated about 30% more bone in the viable grafts, however, this difference was not statistically significant. In the empty chambers, bone was found in comparable quantities. We conclude that there is a qualitative advantage of graft viability in terms of early graft-derived osteogenesis. However, this advantage did not lead to significantly more bone formation in the viable bone grafts. ß

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Maturation of the Posterolateral Spinal Fusion and Its Effect on Load-Sharing of Spinal Instrumentation

Cited by 64 publications

References 21 publications

Incomplete incorporation of morselized and impacted autologous bone graft: A histological study in 4 intracorporally grafted lumbar fractures

Incomplete incorporation of morselized and impacted autologous bone graft: A histological study in 4 intracorporally grafted lumbar fractures

Relationship of donor variables and graft dimension on biomechanical performance of femoral ring allograft

Relevance of bone graft viability in a goat transverse process model

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