Prost Max, Windolf Jochaim, Konieczny Markus Rafael
Department of Orthopedic and Trauma Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany.
Orthop Rev (Pavia). 2022 Aug 25;14(3):37576. doi: 10.52965/001c.37576. eCollection 2022.
To evaluate radiological outcomes following the use of xenogeneic bone graft substitute (BGS) in patients undergoing multisegmental spinal fusion.
Data exists for single level and short segment fusions, there presently is a paucity of data on fusion rate after bone augmentation with BGS in multisegmental posterior spinal fusion (PSF). The leading concern is pseudarthrosis, which often leads to a loss of correction after PSF. Therefore, the bone graft is an essential aspect of PSF.
We retrospectively analysed the radiological data of a consecutive cohort of patients who had been treated for adolescent idiopathic scoliosis (AIS) via multisegmental spinal fusion, in whom a bovine derived BGS had been used and had a complete dataset of 24 months follow-up. The Cobb angle of the main curve was measured pre-operatively and then at 6, 12 and 24 months post-operatively. Loosening of the screws was recorded at the same post-operative time points.
After applying inclusion and exclusion criteria, 28 patients were included. We found no significant change of the cobb angle from the main curve as well as the cobb angle from the thoracic kyphosis during the 24 months of follow up. No patient showed a lack of bony fusion. There was 1 revision surgery, which was due to trauma.
In this cohort, all patients showed successful bone fusion during a 24-month follow-up. Additionally, there was no change in the Cobb angle during the 2-year post-operative period. Our data indicates that the use of bovine-derived BGS supports bone fusion after multisegmental posterior instrumented fusion of the spine.
评估在接受多节段脊柱融合术的患者中使用异种骨移植替代物(BGS)后的影像学结果。
已有关于单节段和短节段融合的数据,但目前关于多节段后路脊柱融合术(PSF)中使用BGS进行骨增强后的融合率数据较少。主要担忧是假关节形成,这常常导致PSF术后矫正丢失。因此,骨移植是PSF的一个重要方面。
我们回顾性分析了一组连续的青少年特发性脊柱侧凸(AIS)患者的影像学数据,这些患者通过多节段脊柱融合术进行治疗,术中使用了牛源BGS,且有完整的24个月随访数据集。术前及术后6、12和24个月测量主弯的Cobb角。在相同的术后时间点记录螺钉松动情况。
应用纳入和排除标准后,纳入28例患者。我们发现在24个月的随访期间,主弯的Cobb角以及胸椎后凸的Cobb角均无显著变化。没有患者显示骨融合不足。有1例翻修手术,原因是外伤。
在这个队列中,所有患者在24个月的随访期间均显示成功的骨融合。此外,术后2年Cobb角没有变化。我们的数据表明,使用牛源BGS可支持脊柱多节段后路器械融合术后的骨融合。