Prospective Comparison of Autograft vs. Allograft for Adult Posterolateral Lumbar Spine Fusion

An, Howard S.; Lynch, Kenneth L.; Toth, Jeffrey M.

doi:10.1097/00002517-199504000-00007

Cited by 173 publications

(78 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Concerns, however, exist regarding the efficacy of frozen or freeze dried allograft, the potential of immunogenicity, and the hazard of microbial contamination, though the rate of disease transmission has proven to be low [1,13,24,26,47]. In addition, the use of allograft is associated with considerable expense, and patients' reservations towards allograft implantation may play an important role as well [23].…”

Section: Introductionmentioning

confidence: 99%

A level-1 pilot study to evaluate of ultraporous β-tricalcium phosphate as a graft extender in the posterior correction of adolescent idiopathic scoliosis

et al. 2008

View full text Add to dashboard Cite

The objective of this study is to compare the clinical and radiographic results of ultraporous b-tricalcium phosphate (b-TCP) versus autogenous iliac crest bone graft (ICBG), through prospective randomized pilot study (EBM-Level 1), as graft extenders in scoliosis surgery. In the posterior correction of scoliosis, local bone resected as part of the procedure is used as the base bone graft material. Supplemental grafting from the iliac crest is considered the gold-standard in posterior spinal fusion. However, autograft is not available in unlimited quantities, and bone harvesting is a source of significant morbidity. Ultraporous b-TCP might be a substitute for ICBG in these patients and thus eliminate donor site morbidity. A total of 40 patients with adolescent idiopathic scoliosis (AIS) were randomized into two treatment groups and underwent corrective posterior instrumentation. In 20 patients, ICBG harvesting was performed whereas the other half received b-TCP (VITOSS Ò ) to augment the local bone graft. If thoracoplasty was performed, the resected rib bone was added in both groups. Patients were observed clinically and radiographically for a minimum of 20 months postoperatively, with a mean follow-up of 4 years. Overall pain and pain specific to the back and donor site were assessed using a visual analog scale (VAS). As a result, both groups were comparable with respect to the age at the time of surgery, gender ratio, preoperative deformity, and hence length of instrumentation. There was no significant difference in blood loss and operative time. In nine patients of the b-TCP group and eight patients of the ICBG group, thoracoplasty was performed resulting in a rib graft of on average 7.9 g in both groups. Average curve correction was 61.7% in the b-TCP group and 61.2% in the ICBG group at hospital discharge (P = 0.313) and 57.2 and 54.3%, respectively, at follow-up (P = 0.109). Loss of curve correction amounted on average 2.6°in the b-TCP group and 4.2°in the comparison group (P = 0.033). In the ICBG group, four patients still reported donor site pain of on average 2/10 on the VAS at last follow-up. One patient in the b-TCP group was diagnosed with a pseudarthrosis at the caudal end of the instrumentation. Revision surgery demonstrated solid bone formation directly above the pseudarthrosis with no histological evidence of b-TCP in the biopsy taken. In conclusion, the use of b-TCP instead of ICBG as extenders of local bone graft yielded equivalent results in the posterior correction of AIS. The promising early results of this pilot study support that b-TCP appears to be an effective bone substitute in scoliosis surgery avoiding harvesting of pelvic bone and the associated morbidity.

show abstract

Section: Introductionmentioning

confidence: 99%

A level-1 pilot study to evaluate of ultraporous β-tricalcium phosphate as a graft extender in the posterior correction of adolescent idiopathic scoliosis

et al. 2008

View full text Add to dashboard Cite

show abstract

“…The graft-healing rate appears to decrease in patients who smoke, are diabetic, have rheumatoid arthritis, or are chronic steroid or nonsteroidal anti-inflammatory drug users [7,8]. Allografts have also been associated with an increased pseudarthrosis rate [1].…”

Section: Introductionmentioning

confidence: 99%

Do autologous growth factors enhance transforaminal lumbar interbody fusion?

Hee

Majd²,

Holt

et al. 2003

European Spine Journal

149

101

View full text Add to dashboard Cite

“…Dessa forma as análises físico-químicas realizadas, demonstraram características minerais e protéicas similares entre as diferentes amostras mesmo após todo o processamento 13 .…”

Section: Resultados Resultados Resultados Resultados Resultadosunclassified

Caracterização físico-química de ossos liofilizados de origem bovina e humana

Gália

Rosito

Mello

et al. 2009

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

OBJETIVO: Verificar as similaridades físico-químicas por meio de análises orgânicas e minerais de ossos liofilizados humanos e bovinos produzidos a partir de um protocolo de processamento desenvolvido pelos autores. MÉTODOS: Determinaram-se os percentuais de extrato etéreo (gordura bruta), proteína total (nitrogênio total) e composição mineral (fósforo total, P2O5 total, cálcio total, sódio total, cinzas e cloretos) das amostras de ossos humanos e bovinos liofilizados. RESULTADOS: O percentual de gordura e de proteína bruta foi de 0.14% e 0.06%, e de 27.20% e 27.53%; enquanto que a composição mineral demonstrou 4.3% e 4.3% de nitrogênio; 11.9% e 11.9% de fósforo total; 27.1% e 27.2% de P2O5; 24.6% e 23.7% de cálcio total (relação Ca/P: 2.06 e 1.99); 0.57% e 0.46% de sódio total; 64.8% e 64.3% de cinzas; e 1.3% e 1.3% de cloretos, para as amostras de osso humano e bovino, respectivamente. Nenhuma diferença estatisticamente significativa foi observada entre ossos bovinos e humanos após o processo de liofilização. CONCLUSÃO: Avaliações de características físicas e químicas de ossos liofilizados bovinos e humanos claramente demonstraram que estes ossos mantêm virtualmente todas as características de osso original e de similaridades com os ossos humanos, levando a um produto final com boa biocompatibilidade.

show abstract

Prospective Comparison of Autograft vs. Allograft for Adult Posterolateral Lumbar Spine Fusion

Cited by 173 publications

References 0 publications

A level-1 pilot study to evaluate of ultraporous β-tricalcium phosphate as a graft extender in the posterior correction of adolescent idiopathic scoliosis

A level-1 pilot study to evaluate of ultraporous β-tricalcium phosphate as a graft extender in the posterior correction of adolescent idiopathic scoliosis

Do autologous growth factors enhance transforaminal lumbar interbody fusion?

Caracterização físico-química de ossos liofilizados de origem bovina e humana

Contact Info

Product

Resources

About