The Effect of Demineralized Bone Matrix as a Graft Enhancer in Posterior Lumbar Interbody Fusion Using Cage and Local Bone Chips

Choi, Dae Jung; Ahn, Dong Ki; Lee, Song; Park, Hoon Seok; Jeon, Young Won; Yang, Seung Jin; Ryu, Chang Wook

doi:10.4184/jkss.2008.15.3.157

Cited by 4 publications

(1 citation statement)

References 37 publications

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“…After removing duplicates, 3606 studies remained, of which 3592 were excluded after reviewing the abstracts and full-text articles. Therefore, eight studies were finally included in this meta-analysis 2,8,12,24,29,30,32,35) .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Fusion Rate between Demineralized Bone Matrix versus Autograft in Lumbar Fusion : Meta-Analysis

Han

Park

Lim

et al. 2020

J Korean Neurosurg Soc

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The demineralized bone matrix (DBM) as the bone graft material to increase the fusion rate was widely used in spinal fusion. The current study aimed to compare the fusion rate of DBM to the fusion rate of autograft in lumbar spine fusion via meta-analysis of published literature. After systematic search, comparative studies were selected according to eligibility criteria. Checklist (risk of bias assessment tool for non-randomized study) was used to evaluate the risk of bias of the included nonrandomized controlled studies. The corresponding 95% confidence interval (95% CI) were calculated. We also used subgroup analysis to analyze the fusion rate of posterolateral lumbar fusion and lumbar interbody fusion. Eight studies were finally included in this meta-analysis. These eight studies included 581 patients. Among them, 337 patients underwent spinal fusion surgery using DBM (DBM group) and 204 patients underwent spinal fusion surgery with mainly autologous bone and without using DBM (control group). There was no significant differences of fusion rate between the two groups in posterolateral fusion analysis (risk ratio [RR], 1.03; 95% CI, 0.90-1.17; p=0.66) and interbody fusion analysis (RR, 1.13; 95% CI, 0.91-1.39; p=0.27). Based on the available evidence, the use of DBM with autograft in posterolateral lumbar spine fusion and lumbar interbody fusion showed a slightly higher fusion rate than that of autograft alone; however, there was no statistically different between two groups.

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Section: Discussionmentioning

confidence: 99%

Comparison of Fusion Rate between Demineralized Bone Matrix versus Autograft in Lumbar Fusion : Meta-Analysis

Han

Park

Lim

et al. 2020

J Korean Neurosurg Soc

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Difference of Fusion Rate in Minimally Invasive Transforaminal Lumbar Interbody Fusion with Autobone and Hydroxyapatite according to Mixture Ratio and Amount of Bone Graft

Yoo

Min

Yoon

et al. 2013

J Korean Orthop Assoc

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Purpose:The aim of this study is to analyze the fusion rate according to the mixture ratio and the amount of bone graft in minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). Materials and Methods: This study included 92 subjects who underwent MI-TLIF. Patients were classified into either group I, in which patients received transplantation with only autogenous bone, group II, in which patients received transplantation with hydroxyapatite mixed with autogenous bone by more than 50%, or group III, in which patients received transplantation with hydroxyapatite mixed with autogenous bone by less than 50%. For analysis of the correlation of amount of bone graft with fusion rate, patients were divided into group A, having less than 12 ml of bone graft, and group B, having more than 12 ml of bone graft. Visual analogue scale and Oswestry disability index were used for clinical assessment, and Burkus' classification method was used for evaluation of bone fusion. Results: Fusion rates of groups I, II, and III according to the mixture ratio were 90.9%, 86.5%, and 86.2%, respectively. The fusion rate increased as the autobone ratio became higher; however, no significant difference was found (p=0.16). The fusion rates were 81.5% and 92.5% in group A and group B, respectively, which were classified according to the volume of bone graft, showing a significant increase in groups with bone graft volume more than 12 ml (p=0.03). Conclusion: A significantly high fusion rate was observed when bone graft volume was more than 12 ml in MI-TLIF. More than 12 ml of bone graft volume is essential for achievement of a satisfactory fusion rate.

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Efficiency and Safety of Demineralized Bone Matrix for Posterolateral Fusion

Ahn

Lee

Park

et al. 2016

J Korean Orthop Assoc

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Purpose:The purpose of this study is to analyze the effects of demineralized bone matrix on posterolateral lumbar fusion. Materials and Methods: From 2009 to 2012, 30 patients who had undergone posterolateral fusions using demineralized bone matrix (group I) and 30 who had received autogenous posterior iliac bone grafts (group II) were investigated. Bone union was determined by evaluating serial simple lumbar radiographs taken during the 24 months after surgery. Bone status was classified according to Lenke's scale and the bone fusion was finally determined by flexion/extension lateral radiographs. We also examined halo signs around the pedicular screws evident on the radiographs, scored back pain using a visual analogue scale (VAS), and Oswestry disability index (ODI) score 2 years after surgery to evaluate clinical status of patients. Results: In group I, 19 patients showed union and 11 patients did not; the values for group II were 22 and 8. These proportions did not differ significantly (p=0.57). Time to union was somewhat shorter in group II (25.3±7.9 weeks), but did not differ significantly from that of group I (p=0.097). No statistical significance in the periscrew Halo count, VAS for back pain, and ODI score was observed between the two groups. Conclusion: The union rate after using demineralized bone matrix for lumbar posterolateral fusion is similar to that attained when autogenous bone grafts are employed, and lacks the morbidity associated with such grafts. Thus, demineralized bone matrix is an effective bone graft substitute when posterolateral fusion surgery of the lumbar spine is required.

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The Effect of Demineralized Bone Matrix as a Graft Enhancer in Posterior Lumbar Interbody Fusion Using Cage and Local Bone Chips

Cited by 4 publications

References 37 publications

Comparison of Fusion Rate between Demineralized Bone Matrix versus Autograft in Lumbar Fusion : Meta-Analysis

Comparison of Fusion Rate between Demineralized Bone Matrix versus Autograft in Lumbar Fusion : Meta-Analysis

Difference of Fusion Rate in Minimally Invasive Transforaminal Lumbar Interbody Fusion with Autobone and Hydroxyapatite according to Mixture Ratio and Amount of Bone Graft

Efficiency and Safety of Demineralized Bone Matrix for Posterolateral Fusion

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