Failure of lumbar disc surgery: management by fusion or arthroplasty?

Kovač, Vladimir

doi:10.1007/s00264-018-4228-9

Cited by 6 publications

(3 citation statements)

References 94 publications

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“…Increasing the interbody fusion rate is the most important goal of surgery for degenerative lumbar disease. Fusion failure may lead to a series of complications such as lumbar instability, pseudarthrosis formation, pedicle screw and rod breakage, and even cage retropulsion (3,4). Although many factors are associated with poor fusion, the choice of bone graft material is undoubtedly crucial for determining its success.…”

Section: Backgroudsmentioning

confidence: 99%

Bone marrow mesenchymal stem cells loaded β-tricalcium phosphate promote lumbar intervertebral fusion: a randomized controlled clinical trial

Zhao

Ding

Wang

et al. 2022

Preprint

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BackgroundAs current stem cell tissue engineering always requires in vitro cell culture, it is subject to restrictions such as extra time cost, ethical problems, and contamination. A novel device named the bone mesenchymal stem cells screen-enrich-combine circulating system(SECCS) was designed to rapidly enrich stem cells and combine with β-tricalcium phosphate to immediately produce bioactive stem cells/β-tricalcium phosphate composites during surgery and implant them into the intervertebral space for intervertebral fusion. Methods37 patients who underwent transforaminal lumbar interbody fusion surgery were included in this study and randomly divided into two groups. One group underwent decompressed laminal bone graft for intervertebral fusion, and the other was given SECCS-prepared β-tricalcium phosphate particles. Cells adhered to β-tricalcium phosphate were eluted for stem cell identification, including scanning electron microscope observation, ALP staining, flow cytometry analysis, and induction for three-line differentiation. Bone marrow was collected before and after enrichment for efficient enrichment analysis. The fusion rate, decrease in intervertebral height, and functional improvement, including Japanese Orthopaedic Association and Oswestry Disability Index scores, were compared between the two groups preoperatively and at 3, 6 and 12 months postoperatively.ResultsThe cells eluted from the β-tricalcium phosphate after screen-enrich-combine circulating system possessed characteristics of stem cell, including fiber-like morphology, positivity for CD44, CD73, CD90, and CD105, negativity for CD34, CD11b, CD19, CD45, and HLA-DR, and could been induced towards osteogenic, adipogenic, and chondrogenic differentiation. The screen-enrich-combine circulating system selectively enriched approximately 84.1% stem cells from the bone marrow in 6 minutes and could be simultaneously implanted into the intervertebral space during operation. Higher early fusion rate, similar intervertebral height decreases, and functional improvement tendencies were observed when stem cells/β-tricalcium phosphate particles were used as fusion scaffolds.ConclusionsThe screen-enrich-combine circulating system could quickly enrich stem cells from bone marrow, and the β-tricalcium phosphate particles prepared by the system showed higher early osteogenic efficiency than autologous laminal bone when used in intervertebral fusion, which provided a new bone scaffold substitute to autologous bone. Trial registration:ChiCTR,ChiCTR-INR-17010805,Registered 6 March, 2017, http://www.chictr.org.cn/showproj.aspx?proj=18386

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Section: Backgroudsmentioning

confidence: 99%

Bone marrow mesenchymal stem cells loaded β-tricalcium phosphate promote lumbar intervertebral fusion: a randomized controlled clinical trial

Zhao

Ding

Wang

et al. 2022

Preprint

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“…In the case of lumbar disc surgery failure, what is the convenient management: fusion or arthroplasty? Kovač [29] has analyzed 80 studies in literature in order to clarify conflicting aspects of fusion and total disc arthroplasty (TDR) surgery. He found that the impact of TDR upon spine surgery is decreasing, currently is less than 2%.…”

Section: Surgical Complications Of Lumbar Disc Herniationmentioning

confidence: 99%

Disc herniation and disc disease: the present and the future of management

Benzakour

Benzakour²

2019

International Orthopaedics (SICOT)

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“…23,24 Recent clinical studies using lumbar arthroplasty have shown sustained clinical and radiographic results over five years, with superior clinical outcomes compared to lumbar arthrodesis. 25,26 Thus, arthroplasty has been increasingly used as an alternative surgical treatment for degenerative disc disease in eligible patients. The purpose of this study was to perform a retrospective analysis of patients with DDD of the lumbar spine who underwent single-level lumbar arthrodesis or arthroplasty in terms of functional capacity and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life Analysis on Patients After Arthroplasty or Lumbar Arthrodesis

Silva

Rodrigues²,

Lopes

et al. 2023

Coluna/Columna

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Objective: To perform a retrospective analysis of patients with degenerative disc disease of the lumbar spine undergoing arthrodesis or lumbar arthroplasty in terms of functional capacity and quality of life. Methods: Retrospective observational study analyzing the medical records of patients undergoing arthrodesis or lumbar arthroplasty, followed-up at an outpatient clinic from 2018 to 2020. Patient characteristics were evaluated; the quality of life through the results of the Short Form 36 Health Survey Questionnaire (SF-36) and the functional capacity using the Oswestry Disability Index (ODI) in the pre-surgical and post-surgical periods (6 months, 1 and 2 years). The criterion to establish statistical significance was p≤0.05. Results: Sixty-one patients were evaluated. After the surgical interventions, the individuals migrated from the classification of invalid (61.4%-64.6%) to minimal/moderate disability (17.7%-25.6%). There was a decline in ODI scores over time of follow-up (p≤0.001) as well as in SF-36 values (p≤0.001) for all surgical techniques. In this regard, evaluating the difference in means revealed the better performance of lumbar arthroplasty (p≤0.001). Conclusion: The data suggest that lumbar arthroplasty offers greater benefits to patients regarding functional capacity and quality of life. Level of Evidence III; Retrospective, descriptive, observational study.

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Failure of lumbar disc surgery: management by fusion or arthroplasty?

Cited by 6 publications

References 94 publications

Bone marrow mesenchymal stem cells loaded β-tricalcium phosphate promote lumbar intervertebral fusion: a randomized controlled clinical trial

Bone marrow mesenchymal stem cells loaded β-tricalcium phosphate promote lumbar intervertebral fusion: a randomized controlled clinical trial

Disc herniation and disc disease: the present and the future of management

Quality of Life Analysis on Patients After Arthroplasty or Lumbar Arthrodesis

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