Girasole Gerard, Muro Gerard, Mintz Abraham, Chertoff Jason
Orthopaedic and Sports Medical Center, Trumbull, CT.
Department of Internal Medicine, University of Florida College of Medicine, Gainesville, FL.
Int J Spine Surg. 2013 Dec;7(1):e95-e100. doi: 10.1016/j.ijsp.2013.08.001.
Transforaminal lumbar interbody fusion (TLIF) with grafting and implant options like iliac crest bone graft (ICBG), recombinant bone morphogenetic protein (rhBMP), and polyetheretherketone (PEEK) cages have been reported to achieve extremely high fusion rates. Unfortunately, these options have also been frequently cited in the literature as causing postoperative morbidity and complications at a high cost. Knowing this, we sought to investigate TLIF using an acid-etched, roughened titanium cage that upregulates osteogenesis to see if similar fusion rates to those cited for ICBG, rhBMP, and PEEK cages could be safely achieved with minimal morbidity and complications.
A radiographic fusion study of 82 patients who underwent TLIF using an acid-etched, roughened titanium cage with demineralized cancellous bone graft was conducted. Fusion was assessed and graded by an independent radiologist using computed tomography scan with sagittal and coronal reconstructions.
Fusion rates at 6 months were 41 of 44 (93.2%) and at 12 months were 37 of 38 (97.4%). There were no radiographic device-related complications.
TLIF with an acid-etched, roughened titanium cage filled with a decalcified bone graft achieved similar fusion rates to historical controls using ICBG, rhBMP, and PEEK.
据报道，经椎间孔腰椎椎体间融合术（TLIF）联合髂嵴骨移植（ICBG）、重组骨形态发生蛋白（rhBMP）和聚醚醚酮（PEEK）椎间融合器等植骨和植入物可实现极高的融合率。不幸的是，这些方法在文献中也经常被提及会导致术后发病率和并发症，且成本高昂。鉴于此，我们试图研究使用一种可上调骨生成的酸蚀粗糙钛笼进行TLIF，以确定是否能以最低的发病率和并发症安全地实现与ICBG、rhBMP和PEEK椎间融合器相似的融合率。
对82例行TLIF并使用酸蚀粗糙钛笼联合脱矿松质骨移植的患者进行影像学融合研究。由一名独立放射科医生使用矢状面和冠状面重建的计算机断层扫描评估并分级融合情况。
6个月时融合率为44例中的41例（93.2%），12个月时为38例中的37例（97.4%）。未出现与器械相关的影像学并发症。
使用填充有脱钙骨移植的酸蚀粗糙钛笼进行TLIF，其融合率与使用ICBG、rhBMP和PEEK的历史对照相似。
