Surgical stabilisation of the rheumatoid cervical spine. A review of indications and results

Zoma, Asad; Sturrock, R D; Fisher, W D; Pa, Freeman; Hamblen, David L.

doi:10.1302/0301-620x.69b1.3818739

Cited by 84 publications

(31 citation statements)

References 10 publications

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“…4 A nonunion may result in inadequate resolution of a patient's clinical symptoms, which can translate into increased probability of additional surgical procedures, with associated morbidity and medical costs. 5 These problems have prompted surgeons to search for alternatives for stimulating bone formation.…”

mentioning

confidence: 99%

Delivery of Lyophilized Nell-1 in a Rat Spinal Fusion Model

Lee

Whang

et al. 2010

Tissue Engineering Part A

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Nell-1 (Nel-like molecule-1; Nel: protein strongly expressed in neural tissue containing epidermal growth factorlike domain) is a promising osteoblast-specific growth factor for osteoinductive therapies that may circumvent adverse effects, such as nonspecific function and ectopic bone formation, associated with more established osteogenic growth factors such as bone morphogenetic proteins. Beta-tricalcium phosphate (b-TCP), an osteoconductive, biodegradable ceramic biomaterial, has been used successfully to deliver osteoinducers for bone regeneration. The aim of this study was to develop a carrier system for efficiently delivering biologically active Nell-1 protein. After a 40% initial burst release, b-TCP particles retained the majority of adsorbed Nell-1 protein in vitro. To test this system in vivo, L4/L5 spinal fusion was performed in three groups of rats (n ¼ 8 each): (1) 5 mg Nell-1 in b-TCP/demineralized bone matrix putty (DBX); (2) 2.5 mg Nell-1 in b-TCP/DBX; (3) b-TCP/DBX only. Fusion was assessed by radiography, palpation, microcomputed tomography, and histological analysis. After 4 weeks, 75% of Nell-1-treated animals exhibited fusion, with a significant increase in new bone volume, whereas only 25% of Nell-free control animals exhibited fusion. Our findings suggest that b-TCP/DBX can increase both the biochemical stability and biological efficiency of Nell-1 protein.

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mentioning

confidence: 99%

Delivery of Lyophilized Nell-1 in a Rat Spinal Fusion Model

Lee

Whang

et al. 2010

Tissue Engineering Part A

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“…In other series published since 1980 concerning atlanto-axial fusions, 75% of 250 patients showed bony fusion (Conaty andMongan 1981, Meijers et al 1984, Thompson and Meyer 1985, Larsson and Toolanen 1986, Fehring and Brooks 1987, Zoma et al 1987, Heywood et al 1988, Clark et al 1989brink and Wigren 1989, Grob et al 1990, Santavirta et al 1991, Vanden Berge et al 1991, Chan et al 1992, Stirrat and Fyfe 1992, Boden et al 1993, Zygmunt et al 1995. However, since bad results are often not published, a true average result is probably lower than 75%.…”

Section: Discussionmentioning

confidence: 97%

OP-1 for cervical spine fusion: Bridging bone in only 1 of 4 rheumatoid patients but prednisolone did not inhibit bone induction in rats

Jeppsson

Säveland

Rydholm

et al. 1999

Acta Orthopaedica Scandinavica

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“…Zoma et al (43) and Conaty and Mongan (44) suggest that some of their 32 and 38 patients, respectively, underwent a cervical procedure primarily for pain relief, but precise indications were not clarified. In our study (13), pain was the indication for surgery in 3 of 4 subjects with lateral mass collapse who underwent posterior cervical fusion.…”

Section: Complications and Therapymentioning

confidence: 99%

“…Even with satisfactory outcomes, neurologic recovery and pain relief were seldom complete. One report emphasized the high failure rate (50%) associated with secondary operations (43). The findings in these series lacked the power to enable investigators to define criteria for surgical intervention in patients with rheumatoid cervical derangement, or to develop guidelines defining the procedures indicated for specific structural lesions, and, intentionally or not, they emphasize the risks involved in such an undertaking.…”

Section: Complications and Therapymentioning

confidence: 99%