108. Posterior bone graft options and success in single-level circumferential lumbar fusions
Achieving spinal fusion requires bone graft and is most reliable using an anterior/posterior technique. Anterior fusion, due to the large bony surface area between the vertebral bodies, results in reliable fusion. Instrumentation which provides stability, also increases the fusion rate. The bone graft for the posterior fusion may come from a variety of sources. Historically, bone graft was obtained from the iliac portion of the patient's own pelvis, IBG, but this may result in additional postoperative pain.
Instrumented posterolateral lumbar fusion (PLF) surgery is commonly used to alleviate pain and other symptoms associated with degenerative conditions of the lumbosacral spine. Although autologous iliac crest bone graft (ICBG) remains the “gold standard” grafting material for these procedures, surgeons have sought alternatives to avoid the potential morbidity associated with ICBG harvest. OSTEOAMP is a novel allograft bone graft substitute (BGS) that has been processed to retain multiple endogenous growth factors.
Lumbar degenerative disc disease contributes to chronic back pain. Mechanisms of intradiscal degeneration have been linked to genetic, metabolic and mechanical imbalance. Symptomatic relief is influenced by meaningful repair of the annulus and by nucleus supplementation.
This study evaluated the efficacy of this combination in TLIF and LLIF surgeries treating adult spinal deformities and degenerative disorders. We retrospectively analysed a consecutive case series of 93 adult patients with lumbar degenerative disease or deformity requiring interbody cages who underwent TLIF or LLIF surgery with SiCaP-packed 3D-printed lamellar titanium cages, performed by a single lead surgeon. The primary endpoint was solid fusion 12 months after surgery, assessed using computed tomography. Secondary endpoints were patient-reported outcomes; EuroQOL five dimensions (EQ-5D), visual analogue scale (VAS) f...
AbstractThe impact of autologous iliac crest bone graft versus BMP-2 to improve fusion rates for posterolateral fusion (PLF) of the lumbar spine remains unanswered. Single-institution-centered data dominate the literature, providing results that may be contradictory or inconclusive. The aim of this paper is to analyze data pooled from multiple well-controlled studies that examined both ICBG and BMP-2 for use in PLF. This meta-analysis also provides details of success in different subsets of patients with variable risk factors for delayed and non-unions. Six high-quality randomized clinical trials were selected. Efficacy, m...
Rationale: Cauda equina syndrome (CES) refers to a group of symptoms that occur when the nerves in the cauda equina become compressed or damaged. The most common etiology of CES is lumbar intervertebral disc herniation, but CES following lumbar spinal surgery is rare, especially without motor dysfunction. Herein, we illustrate a case of CES that developed as a complication of spinal surgery and to deduce its possible underlying cause. Patient concerns: A 46-year-old man experienced lumbago, bilateral shank pain, and numbness with neurogenic claudication for 3 years due to degenerative lumbar disc herniation and spinal...
CONCLUSIONS: Using local bone dust as cage filling material resulted in fusion rates similar to those for an iliac bone graft, while avoiding potential complications and pain caused by iliac bone harvesting. A higher rate of extragraft bone bridge formation was achieved by implanting local bone dust outside the cage. PMID: 31174186 [PubMed - as supplied by publisher]
ConclusionsTo our knowledge, this is the first report of spondylodiscitis caused byAspergillus terreus after an abdominal penetrating injury. The histological finding of chronic suppurative osteomyelitis and the radiological findings strongly suggested direct inoculation ofAspergillus terreus.
(1) To assess the incidence of postoperative opioid prescription refills in patients undergoing osteochondral autograft transplant (OAT) and osteochondral allograft transplant (OCA) procedures of the knee; (2) to evaluate the effect of filling preoperative opioid prescriptions on the incidence of postoperative filling; and (3) to assess the impact of age, sex, and diagnosis of low-back pain on postoperative opioid prescription filling.
Conclusion. Preoperative uNTx was greater in patients with successful ACDF fusion compared with patients with pseudarthrosis at 6 months and 1 year. A negative correlation was found between preoperative uNTx and motion on dynamic imaging. These results suggest that uNTx could serve to identify patients at risk for pseudarthrosis after ACDF. Level of Evidence: 3
Hey forum, weigh-in on this: 83 y/o F with new L5 compression fracture from 2 months back (30% superior endplate compression) with fracture lines that extend into the bilateral pedicles, L>R. I want to fix this thing, but she also has history of L4-S1 posterior fusion with bone graft (fusion done in 1975) going right over the pedicle shadow. Hard to make out any definable anatomy needed on left, but I do see my landmarks on right. Does anyone have experience trying to fix fractures in... Compression fx/vertebroplasty question