Comparison of Allograft and Autograft in Lumbar Fusion for Lumbar Degenerative Diseases: A Systematic Review

Zhong, Lintao; Wang, Chaohui; Cui, Wei-Liang

doi:10.3109/08941939.2016.1166534

Cited by 19 publications

(13 citation statements)

References 25 publications

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“…The increased CT fusion scores observed in this study for syngeneic iliac allograft compared to autograft bone is in contrast to several clinical fusion studies which also used radiographic or CT measures of fusion to compare autograft to frozen allograft [25,26]. For example, recent meta-analyses by several groups have found comparable lumbar fusion rates between patients treated with allograft and autograft iliac crest bone, with no significant differences in disability or pain scores [27,28]. While this discrepancy between our observations in a preclinical animal model and clinical studies may be due to differences in species, the fresh and syngeneic nature of the allografts used in this study may also be contributing factors.…”

Section: Discussioncontrasting

confidence: 80%

Comparing the efficacy of syngeneic iliac and femoral allografts with iliac crest autograft in a rat model of lumbar spinal fusion

et al. 2020

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Background Despite widespread use of femoral-sourced allografts in clinical spinal fusion procedures and the increasing interest in using femoral reamer–irrigator–aspirator (RIA) autograft in clinical bone grafting, few studies have examined the efficacy of femoral grafts compared to iliac crest grafts in spinal fusion. The objective of this study was to directly compare the use of autologous iliac crest with syngeneic femoral and iliac allograft bone in the rat model of lumbar spinal fusion. Methods Single-level bilateral posterolateral intertransverse process lumbar spinal fusion surgery was performed on Lewis rats divided into three experimental groups: iliac crest autograft, syngeneic iliac crest allograft, and syngeneic femoral allograft bone. Eight weeks postoperatively, fusion was evaluated via microCT analysis, manual palpation, and histology. In vitro analysis of the colony-forming and osteogenic capacity of bone marrow cells derived from rat femurs and hips was also performed to determine whether there was a correlation with the fusion efficacy of these graft sources. Results Although no differences were observed between groups in CT fusion mass volumes, iliac allografts displayed an increased number of radiographically fused fusion masses and a higher rate of bilateral fusion via manual palpation. Histologically, hip-derived grafts showed better integration with host bone than femur derived ones, likely associated with the higher concentration of osteogenic progenitor cells observed in hip-derived bone marrow. Conclusions This study demonstrates the feasibility of using syngeneic allograft bone in place of autograft bone within inbred rat fusion models and highlights the need for further study of femoral-derived grafts in fusion.

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Section: Discussioncontrasting

confidence: 80%

Comparing the efficacy of syngeneic iliac and femoral allografts with iliac crest autograft in a rat model of lumbar spinal fusion

et al. 2020

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“…They include lumbar disc herniation, lumbar spinal stenosis, lumbar degenerative spondylolisthesis, lumbar discogenic low back pain, lumbar spondylolysis, and lumbar degenerative scoliosis (DS), among others. [7] Lumbar disc herniation is the most common and complicated type of DDD. Minimally invasive treatments for lumbar disc herniation include non-surgical intervention, endoscopic surgery, and open surgery.…”

Section: Introductionmentioning

confidence: 99%

Clinical effects of transforaminal and interlaminar percutaneous endoscopic discectomy for lumbar disc herniation

Jiang

Zhou

2018

Medicine

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The aim of this study is to observe the therapeutic effect of percutaneous endoscopic discectomy and its influencing factors for lumbar disc herniation and compare the advantages and disadvantages of transforaminal and interlaminar of percutaneous endoscopy.Data from 143 patients with lumbar disc herniation were respectively collected, including demographic and clinical data. Study population were divided into curative effect group and poor curative effect group, and logistic regression was used to explore the influencing factors of curative effect. The operation data and pre-and post-operation scores were compared to explore the effect of transforaminal and interlaminar approach on surgery efficacy.The rate of curative effect was 93.7%. 120 patients were classified as curative group and 23 patients were categorized as poor effective group. Univariate analysis found that the patients in the curative effect group tended to receive the interlaminar approach (58.3% vs 34.8%, P = .038). Multivariate logistic regression did not find operation approach was not related to curative effect of operation (transforaminal and interlaminar). But age ≥45 (odd risk (OR) = 6.43, P = .016), course of disease >12 month (OR = 3.77, P = .003), back and leg pain (OR = 3.46, P = .026), history of trauma (OR = 3.88, P = .014), Pfirrmann level IV (OR = 4.84, P = .004), and pre-Visual Analogue Scale (VAS) <5.3 (OR = 3.63, P = .015) were associated with operation efficacy. Compared with transforaminal group, the interlaminar group has less operative time (P = .000), less fluoroscopy time (P = .000), less puncture time (P = .000), less blood loss (P = .011).The transforaminal or interlaminar did not affect the treatment efficacy of percutaneous endoscopic discectomy for lumbar disc herniation. The selection of surgery approach depended on anatomical structure and physiological characteristics. It should be noted that 45 years of age or older, in the course of more than 12 months, both lumbocrural pain and lumbar disc herniation with grade IV, with history of trauma, may have impact on the efficacy of surgery.

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“…Demineralized bone is acellular and less osteoconductive than autogenous bone, due to the acid extraction. The quantity and type of growth factors and cytokines influence the osteoinductive capacity of the demineralized bone graft (20). The extracellular matrix stimulates new bone formation via non-collagenous proteins and growth factors (21).…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of treatment with cage‑shaped demineralized bone plus local bone grafts vs. autogenous iliac crest bone grafts in instrumented single‑level lumbar fusion: A retrospective cohort study

Zhao

Qin

Wang³

et al. 2019

Exp Ther Med

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The aim of the present study was to compare the clinical outcomes of cage-shaped demineralized bone plus local bone grafts (CDBLG) with those of autogenous iliac crest bone grafts (ICBG) implanted for the treatment of single-level lumbar intervertebral disc degenerative diseases. A total of 69 cases of degenerative spinal disorder treated between January 2011 and December 2013 were retrospectively analyzed. Of these, 44 were treated with CDBLG and 25 with autogenous ICBG. All fusions were instrumented single level. Fusion was assessed after 6, 12 and 24 months by X-ray and CT scans post-operatively. Clinical outcomes were determined during follow-up and assessments included the Oswestry Disability Index, Visual Analogue Scale for back and leg pain and the Short Form-36 general health survey physical component summary. The results indicated that the overall fusion rate at 24 months post-operatively was higher in the ICBG group compared with that in the CDBLG group, although not significantly (P>0.05). All other outcome measures were significantly improved in the two groups after the surgery (P<0.05), but no significant differences were observed between the two groups (P>0.05). Blood loss and mean duration of surgery in the CDBLG group were significantly lower compared with those in the ICBG group (P<0.05). In conclusion, CDBLG achieved a similar fusion rate and clinical outcome as ICBG but was associated with significantly reduced blood loss and mean duration of surgery. In conclusion, the present study provided CDBLG bone graft as an alternative option for single-level fusion.

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Comparison of Allograft and Autograft in Lumbar Fusion for Lumbar Degenerative Diseases: A Systematic Review

Abstract: Both allograft and autograft provide acceptable outcomes for spinal fusion.

Cited by 19 publications

References 25 publications

Comparing the efficacy of syngeneic iliac and femoral allografts with iliac crest autograft in a rat model of lumbar spinal fusion

Comparing the efficacy of syngeneic iliac and femoral allografts with iliac crest autograft in a rat model of lumbar spinal fusion

Clinical effects of transforaminal and interlaminar percutaneous endoscopic discectomy for lumbar disc herniation

Clinical outcomes of treatment with cage‑shaped demineralized bone plus local bone grafts vs. autogenous iliac crest bone grafts in instrumented single‑level lumbar fusion: A retrospective cohort study

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