Anterior Lumbar Interbody Fusion with Processed Sea Coral (Coralline Hydroxyapatite) as Part of a Circumferential Fusion
| Autor: | Marcus Timlin, John S. Thalgott, Zendek Klezl, James M. Giuffre |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male musculoskeletal diseases Ceramics Facet (geometry) Coralline hydroxyapatite Circumferential fusion Screw fixation Lumbar Lumbar interbody fusion Humans Medicine Orthopedics and Sports Medicine Intervertebral Disc Aged Retrospective Studies Orthodontics Retrospective review Bone Transplantation Lumbar Vertebrae business.industry Anatomy Middle Aged musculoskeletal system humanities Radiography Spinal Fusion Treatment Outcome surgical procedures operative Female Spinal Diseases Hydroxyapatites Neurology (clinical) business Low Back Pain Porosity |
| Zdroj: | Spine. 27:E518-E525 |
| ISSN: | 0362-2436 |
| DOI: | 10.1097/00007632-200212150-00011 |
| Popis: | A retrospective review of 20 patients undergoing circumferential lumbar fusion with coralline hydroxyapatite blocks anteriorly and autograft with transpedicular or translaminar facet screw fixation posteriorly.To examine the efficacy of coralline hydroxyapatite as a bone graft substitute for anterior lumbar interbody fusion.Autograft is the gold standard for bone grafting in the anterior lumbar spine. Harvesting bone from the iliac crest leads to significant postoperative pain and morbidity. Femoral ring allograft is a widely used alternative to autograft but has some inherent problems. Coralline hydroxyapatite was shown to be 100% successful for anterior cervical fusion when combined with rigid plating.A retrospective review of 20 patients with low back pain and indicated for surgical intervention. A circumferential instrumented fusion was performed with coralline hydroxyapatite blocks anteriorly and transpedicular or translaminar facet fixation and autograft posteriorly. All patients reached a minimum 3-year clinical and radiologic follow-up.Radiographic follow-up yielded a solid arthrodesis rate of 93.8% by level (30 of 32 disc spaces) and 90% by patient (18 of 20). Clinical follow-up generated a mean pain reduction of 61.8% with clinical success demonstrated in 80% (16 of 20) of all patients who reported good or excellent pain relief. Eight of 12 (66.7%) patients employed before surgery returned to work in some capacity.Coralline hydroxyapatite is a practicable anterior lumbar interbody fusion alternative to autograft and allograft as part of a circumferential fusion with rigid posterior fixation. It is not recommended for stand-alone anterior lumbar interbody fusion without further study. |
| Databáze: | OpenAIRE |
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