Nonunion of the Spine

Lee, Cathy; Dorcil, Job; Radomisli, Timothy E.

doi:10.1097/00003086-200402000-00012

Cited by 85 publications

(51 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For successful spinal fusion adequate amount of the graft material is required, which contains (1) osteogenic cells capable to synthesize new bone, (2) osteoinductive factors promoting the osteoblastic differentiation of stem cells and (3) osteoconductive scaffolds facilitating revascularization and ingrowth of bone [8,22]. From the available options of graft choice, only autogenous bone graft, possesses all these three properties.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of porous hydroxyapatite bone chip as an extender of local bone graft in posterior lumbar interbody fusion

et al. 2011

View full text Add to dashboard Cite

Objective To evaluate whether a synthetic bone chip made of porous hydroxyapatite can effectively extend local decompressed bone graft in instrumented posterior lumbar interbody fusion (PLIF). Methods 130 patients, 165 segments, who had undergone PLIF with cages and instrumentation for single or double level due to degenerative conditions, were investigated retrospectively by independent blinded observer. According to the material of graft, patients were divided into three groups. HA group (19 patients, 25 segments): with hydroxyapatite bone chip in addition to autologous local decompressed bone, IBG group (25 patients, 28 segments): with autologous iliac crest bone graft in addition to local decompressed bone and LB group (86 patients, 112 segments): with local decompressed bone only. Radiologic and clinical outcome were compared among groups and postoperative complications, transfusion, time and cost of operation and duration of hospitalization were also investigated. Results Radiologic fusion rate and clinical outcome were not different. Economic cost, transfusion and hospital stay were also similar. But operation time was significantly longer in IBG group than in other groups. There were no lasting complications associated with HA and LB group with contrast to five cases with persisting donor site pain in IBG group. Conclusion Porous hydroxyapatite bone chip is a useful bone graft extender in PLIF when used in conjunction with local decompressed bone.

show abstract

Section: Discussionmentioning

confidence: 99%

The efficacy of porous hydroxyapatite bone chip as an extender of local bone graft in posterior lumbar interbody fusion

et al. 2011

View full text Add to dashboard Cite

show abstract

“…In the last decade, the rate of rhBMP-2 utilization in this patient population has significantly increased particularly in the treatment of spondylolisthesis [59]. Isthmic spondylolisthesis in adolescent patients poses a challenging fusion environment, which has encouraged surgeons to implement rhBMP-2 in order to increase the likelihood of arthrodesis [63].…”

Section: Argument In Favor Of Bmp Utilization In Adolescent Patientsmentioning

confidence: 99%

Point-counter-point debate: the association between recombinant human bone morphogenetic protein utilization and complications in spine surgery

Siemionow

Sundberg

Tyrakowski³

et al. 2014

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Bone morphogenetic proteins (BMPs) have been utilized in spine surgery for over 10 years as a bone graft substitute. Potential BMP-related adverse effects including retrograde ejaculation and heterotopic neuroforaminal bone formation have been described. Additionally, some studies have suggested an association between BMP and cancer. Inconsistencies exist in the published spine literature with regards to the incidence and association of complications with BMP utilization. In a point-counterpoint format, this article discusses the current evidence concerning the relationship between the utilization of BMP in spinal fusion and the risk of cancer, retrograde ejaculation (RE), neuroforaminal bone formation, and its role in anterior cervical spine surgery and adolescents.Keywords Bone morphogenetic protein . Retrograde ejaculation . Anterior cervical fusion . Neuroforaminal bone growth . Cancer Point-counterpointRetrograde Ejaculation (RE) RE occurs secondary to impaired function of the internal vesicle sphincter muscle. Anterior lumbar approaches, particularly at the L5-S1 level, carry a greater potential for damage to the superior hypogastric sympathetic plexus, which innervates the internal vesicle sphincter muscle. Other etiologies of RE including diabetes, benign prostate hypertrophy and its treatment, multiple sclerosis, pelvic trauma, and pelvic or rectal surgery [1][2][3][4][5][6]. RE following anterior lumbar spine surgery is also purported to be related to the surgical approach [7][8][9].Burkus et al first published a prospective, randomized, nonblinded FDA-approved study concerning the use of rhBMP-2 in ALIF [8]. Six males (4.1 %; 6/146) reported RE following surgery, of which 4 underwent a transperitoneal approach (TPA) (13.3 %; 4 of all 30 males that underwent TPA) and 2 underwent a retroperitoneal approach (RPA) (1.8 %; 2 of 116 males that underwent RPA). Since the difference in RE between the TPA and RPA groups was statistically significant the authors concluded that a TPA was associated with a higher risk of RE. No comparison in RE between the investigational and control group was performed. The reported differences between the 2 approaches persisted at the 2-year follow-up period [10]. However, in 2010 Smoljanovic et al reviewed the data by Burkus et al [11] and reported that all 6 patients with RE had received rhBMP-2. Thus, the prevalence of RE in the investigational group (rhBMP-2) would have been 7.7 % (6/78 males), which was significantly greater than the control group (ICBG). The reason for ignoring the relationship between RE and rhBMP-2 was questioned, which sparked an intense debate over the potential association between the utilization of rhBMP-2 and RE.Correlation between rhBMP-2 utilization and RE Curr Rev Musculoskelet Med (2014) 7:200-207 DOI 10.1007/s12178-014-9219-x patients (7.2 %) in the rhBMP-2 group developed RE while only 1 of 174 patients (0.6 %; 1/69) reported RE in the control group. Significant differences in RE were also evident among patients that underwent a singl...

show abstract

“…Introduction Lumbar spine fusion is commonly used for managing many degenerative problems; nevertheless, reported pseudarthrosis rates varied between 5-56% for fusions of the lumbar spine 8,17,33 . Nonunion of the spine is difficult to diagnose at an early stage because not all patients are symptomatic 17,21,28 .…”

Section: Tansforaminal Lumbar Interbody Fusion (Tlif) For Revision Ofmentioning

confidence: 99%

Transforaminal Lumbar Interbody Fusion (TLIF) for Revision of Failed Posterolateral Spinal Fusion

El-Sharkawi¹,

Koptan²,

ElMiligui³

2012

Egyptian Spine Journal

View full text Add to dashboard Cite

show abstract

Nonunion of the Spine

Cited by 85 publications

References 28 publications

The efficacy of porous hydroxyapatite bone chip as an extender of local bone graft in posterior lumbar interbody fusion

The efficacy of porous hydroxyapatite bone chip as an extender of local bone graft in posterior lumbar interbody fusion

Point-counter-point debate: the association between recombinant human bone morphogenetic protein utilization and complications in spine surgery

Transforaminal Lumbar Interbody Fusion (TLIF) for Revision of Failed Posterolateral Spinal Fusion

Contact Info

Product

Resources

About