Allogenic versus autologous cancellous bone in lumbar segmental spondylodesis: a randomized prospective study

Putzier, Michael; Strube, Patrick; Funk, Julia F.; Groß, Christian; Mönig, Hans-Joachim; Perka, Carsten; Pruß, Axel

doi:10.1007/s00586-008-0875-7

Cited by 84 publications

(56 citation statements)

References 40 publications

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“…Some studies have demonstrated that the use of iliac crest bone graft has substantial donor-site morbidity 6,7,16,17,[20][21][22][23] . However, other authors have reported that assessment of iliac crest donor-site pain is overestimated 15,24 and confounded by the concomitant pain from lumbar radiculopathy 17,18,25,26 .…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Iliac Crest Autograft on the Outcome of Fusion in the Setting of Degenerative Spondylolisthesis

Radcliff¹,

Hwang²,

Hilibrand³

et al. 2012

The Journal of Bone and Joint Surgery-American Volume

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The outcome scores associated with the use of posterior iliac crest bone graft for lumbar spinal fusion were not significantly lower than those after fusion without iliac crest autograft. Conversely, iliac crest bone-grafting was not associated with an increase in the complication rates or rates of reoperation. On the basis of these results, surgeons may choose to use iliac crest bone graft on a case-by-case basis for lumbar spinal fusion.

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Section: Discussionmentioning

confidence: 99%

“…Iliac crest autograft has been commonly used for achieving a fusion in lumbar spine surgery [3][4][5] . However, short and long-term morbidity associated with iliac crest bone-graft harvest is a concern to many surgeons and patients [6][7][8][9] .…”

mentioning

confidence: 99%

The Effect of Iliac Crest Autograft on the Outcome of Fusion in the Setting of Degenerative Spondylolisthesis

Radcliff¹,

Hwang²,

Hilibrand³

et al. 2012

The Journal of Bone and Joint Surgery-American Volume

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“…The principal merits of cancellous grafts are their safety, including a low risk of transplant rejection and disease transmission, and their excellent clinical success rate. However, the supply of donor bone grafts is restricted, and donor site morbidity increases if a larger autograft is harvested, in addition to other disadvantages, such as increased blood loss, potential wound infection and the prolonged anesthetic time [137,177]. In particular, although the incidence is low, complications associated with the harvesting of iliac crest bone, such as persistent postoperative pain and nerve/arterial injury, have been reported [170].…”

Section: Tissue Grafts Of Human Originmentioning

confidence: 99%

Advancing biomaterials of human origin for tissue engineering

Chen

Liu

2016

Progress in Polymer Science

959

513

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Biomaterials have played an increasingly prominent role in the success of biomedical devices and in the development of tissue engineering, which seeks to unlock the regenerative potential innate to human tissues/organs in a state of deterioration and to restore or reestablish normal bodily function. Advances in our understanding of regenerative biomaterials and their roles in new tissue formation can potentially open a new frontier in the fast-growing field of regenerative medicine. Taking inspiration from the role and multi-component construction of native extracellular matrices (ECMs) for cell accommodation, the synthetic biomaterials produced today routinely incorporate biologically active components to define an artificial in vivo milieu with complex and dynamic interactions that foster and regulate stem cells, similar to the events occurring in a natural cellular microenvironment. The range and degree of biomaterial sophistication have also dramatically increased as more knowledge has accumulated through materials science, matrix biology and tissue engineering. However, achieving clinical translation and commercial success requires regenerative biomaterials to be not only efficacious and safe but also cost-effective and convenient for use and production. Utilizing biomaterials of human origin as building blocks for therapeutic purposes has provided a facilitated approach that closely mimics the critical aspects of natural tissue with regard to its physical and chemical properties for the orchestration of wound healing and tissue regeneration. In addition to directly using tissue transfers and transplants for repair, new applications of human-derived biomaterials are now focusing on the use of naturally occurring biomacromolecules, decellularized ECM scaffolds and autologous preparations rich in growth factors/non-expanded stem cells to either target acceleration/magnification of the body's own repair capacity or use nature's paradigms to create new tissues for restoration. In particular, there is increasing interest in separating ECMs into simplified functional domains and/or biopolymeric assemblies so that these components/constituents can be discretely exploited and manipulated for the production of bioscaffolds and new biomimetic biomaterials. Here, following an overview of tissue auto-/allo-transplantation, we discuss the recent trends and advances as well as the challenges and future directions in the evolution and application of human-derived biomaterials for reconstructive surgery and tissue engineering. In particular, we focus on an exploration of the structural, mechanical, biochemical and biological information present in native human tissue for bioengineering applications and to provide inspiration for the design of future biomaterials.

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“…Based on a recently published protocol, 15 which is only briefly presented here, patients received an artifact-reduced CT (multidetector CT [MDCT] 16-Zeilen, Toshiba) of the index and superior adjacent segments for registration of implant-associated complications, such as migration, loosening, or nonunion (according to criteria published elsewhere 28 ), as well as for 3D measurement of the paravertebral muscles at 1 week and at 12 months after surgery.…”

Section: Data Collectionmentioning

confidence: 99%

Postoperative posterior lumbar muscle changes and their relationship to segmental motion preservation or restriction: a randomized prospective study

Strube¹,

Putzier

Streitparth

et al. 2016

SPI

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OBJECT To date, it remains unclear whether the preservation of segmental motion by total disc replacement (TDR) or motion restriction by stand-alone anterior lumbar interbody fusion (ALIF) have an influence on postoperative degeneration of the posterior paraspinal muscles or the associated clinical results. Therefore, the purpose of the present prospective randomized study was to evaluate the clinical parameters and 3D quantitative radiological changes in the paraspinal muscles of the lumbar spine in surgically treated segments and superior adjacent segments after ALIF and TDR. METHODS A total of 50 patients with chronic low-back pain caused by single-level intervertebral disc degeneration (Pfirrmann Grade ≥ III) and/or osteochondrosis (Modic Type ≤ 2) without symptomatic facet joint degeneration (Fujiwara Grade ≤ 2, infiltration test) of the segments L4–5 or L5–S1 were randomly assigned to 2 treatment groups. Twenty-five patients were treated with a stand-alone ALIF and the remaining 25 patients underwent TDR. For ALIF and TDR, a retroperitoneal approach was used. At 1 week and at 12 months after surgery, CT was used to analyze paraspinal lumbar muscle tissue volume and relative fat content. Residual muscle tissue volume at 12 months and change in the relative fat content were compared between the groups. In addition, clinical parameters (visual analog scale [VAS] for low-back pain and Oswestry Disability Index [ODI] Questionnaire Version 2 for function) were compared. RESULTS Compared with 1 week after surgery, the radiological analysis at 12 months revealed a small decrease in the posterior muscle volume (the mean decrease was < 2.5%), along with a small increase in the relative fat content (the mean increase was < 1.9%), in both groups at the index and superior adjacent segments. At the adjacent segment, the ALIF group presented significantly less muscle tissue volume atrophy and a smaller increase in fat content compared with the TDR group. At final follow-up, the clinical parameters related to pain and function were significantly improved in both groups compared with 1 week postsurgery, but there were no differences between the groups. CONCLUSIONS Motion restriction via stand-alone ALIF and motion preservation via TDR both present small changes in the posterior lumbar paraspinal muscles with regard to volume atrophy or fatty degeneration at the index and superior adjacent segments. Therefore, although the clinical outcome was not affected by the observed muscular changes, the authors concluded that the expected negative influence of motion restriction on the posterior muscles compared with motion preservation does not occur on a clinically relevant level.

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Allogenic versus autologous cancellous bone in lumbar segmental spondylodesis: a randomized prospective study

Abstract: The current gold standard in lumbar fusion consists of transpedicular fixation in combination with an interbody interponate of autologous bone from iliac crest.

Cited by 84 publications

References 40 publications

The Effect of Iliac Crest Autograft on the Outcome of Fusion in the Setting of Degenerative Spondylolisthesis

The Effect of Iliac Crest Autograft on the Outcome of Fusion in the Setting of Degenerative Spondylolisthesis

Advancing biomaterials of human origin for tissue engineering

Postoperative posterior lumbar muscle changes and their relationship to segmental motion preservation or restriction: a randomized prospective study

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