Potential significance of facet joint fusion or posteromedial fusion observed on CT imaging following attempted posterolateral or posterior interbody fusion

Kim, David H.; Hwang, Raymond; Lee, Gyu Ho; Joshi, Riya; Baker, Kevin C.; Arnold, Paul M.; Sasso, Rick C.; Park, Daniel; Fischgrund, Jeffrey S.

doi:10.1016/j.spinee.2019.10.010

Cited by 10 publications

(8 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An additional interbody fusion procedure negatively influenced PLF, probably due to the associated facetectomies. 27 This effect was not observed in the present study, possibly because we mostly performed posterior instead of transforaminal interbody fusion. Contrary, a positive relation between successful IBF and PLF at both 1 and 2-year follow-up was found.…”

Section: Discussioncontrasting

confidence: 52%

Increasing Fusion Rate Between 1 and 2 Years After Instrumented Posterolateral Spinal Fusion and the Role of Bone Grafting

Lehr

Öner

Delawi

et al. 2020

Spine

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 52%

Increasing Fusion Rate Between 1 and 2 Years After Instrumented Posterolateral Spinal Fusion and the Role of Bone Grafting

Lehr

Öner

Delawi

et al. 2020

Spine

View full text Add to dashboard Cite

show abstract

“…Further elaboration of a well-defined and detailed systematic assessment method is a prerequisite for both clinical practice and research. Recognizing the limited feasibility of surgical exploration as the reference standard, further research should be directed at studying the accuracy of assessment methods using the current generations of CT scanners and implants, as well as the location of imaging-based fusion (between transverse processes or between facets) that correlates best with a true solid fusion 27,43,44 . Another underexplored aspect, related to the quality of the fusion mass, is the distinction between (potential) ongoing bone formation and nonunion.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Posterolateral Lumbar Fusion

et al. 2022

View full text Add to dashboard Cite

Background:Noninvasive assessment of osseous fusion after spinal fusion surgery is essential for timely diagnosis of patients with symptomatic pseudarthrosis and for evaluation of the performance of spinal fusion procedures. There is, however, no consensus on the definition and assessment of successful posterolateral fusion (PLF) of the lumbar spine. This systematic review aimed to (1) summarize the criteria used for imaging-based fusion assessment after instrumented PLF and (2) evaluate their diagnostic accuracy and reliability.Methods:First, a search of the literature was conducted in November 2018 to identify reproducible criteria for imaging-based fusion assessment after primary instrumented PLF between T10 and S1 in adult patients, and to determine their frequency of use. A second search in July 2021 was directed at primary studies on the diagnostic accuracy (with surgical exploration as the reference) and/or reliability (interobserver and intraobserver agreement) of these criteria. Article selection and data extraction were performed by at least 2 reviewers independently. The methodological quality of validation studies was assessed with the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) and QAREL (Quality Appraisal of Reliability Studies).Results:Of the 187 articles included from the first search, 47% used a classification system and 63% used ≥1 descriptive criterion related to osseous bridging (104 articles), absence of motion (78 articles), and/or absence of static signs of nonunion (39 articles). A great variation in terminology, cutoff values, and assessed anatomical locations was observed. While the use of computed tomography (CT) increased over time, radiographs remained predominant. The second search yielded 11 articles with considerable variation in outcomes and quality concerns. Agreement between imaging-based assessment and surgical exploration with regard to demonstration of fusion ranged between 55% and 80%, while reliability ranged from poor to excellent.Conclusions:None of the available criteria for noninvasive assessment of fusion status after instrumented PLF were demonstrated to have both sufficient accuracy and reliability. Further elaboration and validation of a well-defined systematic CT-based assessment method that allows grading of the intertransverse and interfacet fusion mass at each side of each fusion level and includes signs of nonunion is recommended.Level of Evidence:Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

show abstract

“…e64(16) TH E J O U R N A L O F B O N E & JOINT SURGERY d J B J S . O R G VOLUME 103-A d N U M B E R16 d AUGUST 18, 2021 BMP/ACTIVIN A CHIMERA I N D U C E S S P I N E FUSION I N PRIMATES AT LOWER C O N C E N T R AT I O N S T H A N BMP-2…”

mentioning

confidence: 99%

“…Local bone obtained from the laminectomy eliminates the second surgical site. However, available volume can be limiting or it can be unavailable because of a prior laminectomy 12-16 . Local bone osteogenic capacity may be reduced compared with ICBG because of a higher cortical-to-cancellous bone ratio or suboptimal graft preparation.…”

mentioning

confidence: 99%

A BMP/Activin A Chimera Induces Posterolateral Spine Fusion in Nonhuman Primates at Lower Concentrations Than BMP-2

Seeherman¹,

Wilson

Vanderploeg

et al. 2021

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

Background:Supraphysiologic bone morphogenetic protein (BMP)-2 concentrations are required to induce spinal fusion. In this study, a BMP-2/BMP-6/activin A chimera (BV-265), optimized for BMP receptor binding, delivered in a recombinant human collagen:CDHA [calcium-deficient hydroxyapatite] porous composite matrix (CM) or bovine collagen:CDHA granule porous composite matrix (PCM), engineered for optimal BV-265 retention and guided tissue repair, was compared with BMP-2 delivered in a bovine absorbable collagen sponge (ACS) wrapped around a MASTERGRAFT Matrix (MM) ceramic-collagen rod (ACS:MM) in a nonhuman primate noninstrumented posterolateral fusion (PLF) model.Methods:In vivo retention of 125I-labeled-BV-265/CM or PCM was compared with 125I-labeled-BMP-2/ACS or BMP-2/buffer in a rat muscle pouch model using scintigraphy. Noninstrumented PLF was performed by implanting CM, BV-265/CM, BV-265/PCM, or BMP-2/ACS:MM across L3-L4 and L5-L6 or L3-L4-L5 decorticated transverse processes in 26 monkeys. Computed tomography (CT) images were acquired at 0, 4, 8, 12, and 24 weeks after surgery, where applicable. Manual palpation, μCT (microcomputed tomography) or nCT (nanocomputed tomography), and histological analysis were performed following euthanasia.Results:Retention of 125I-labeled-BV-265/CM was greater than BV-265/PCM, followed by BMP-2/ACS and BMP-2/buffer. The CM, 0.43 mg/cm3 BMP-2/ACS:MM, and 0.05 mg/cm3 BV-265/CM failed to generate PLFs. The 0.15-mg/cm3 BV-265/CM or 0.075-mg/cm3 BV-265/PCM combinations were partially effective. The 0.25-mg/cm3 BV-265/CM and 0.15 and 0.3-mg/cm3 BV-265/PCM combinations generated successful 2-level PLFs at 12 and 24 weeks.Conclusions:BV-265/CM or PCM can induce fusion in a challenging nonhuman primate noninstrumented PLF model at substantially lower concentrations than BMP-2/ACS:MM.Clinical Relevance:BV-265/CM and PCM represent potential alternatives to induce PLF in humans at substantially lower concentrations than BMP-2/ACS:MM.

show abstract

Potential significance of facet joint fusion or posteromedial fusion observed on CT imaging following attempted posterolateral or posterior interbody fusion

Cited by 10 publications

References 15 publications

Increasing Fusion Rate Between 1 and 2 Years After Instrumented Posterolateral Spinal Fusion and the Role of Bone Grafting

Increasing Fusion Rate Between 1 and 2 Years After Instrumented Posterolateral Spinal Fusion and the Role of Bone Grafting

Assessment of Posterolateral Lumbar Fusion

A BMP/Activin A Chimera Induces Posterolateral Spine Fusion in Nonhuman Primates at Lower Concentrations Than BMP-2

Contact Info

Product

Resources

About