Matsukura Yu, Hirai Takashi, Hashimoto Motonori, Sakaeda Kentaro, Sakai Kenichiro, Torigoe Ichiro, Yamada Kentaro, Tomori Masaki, Sakaki Kyohei, Morishita Shingo, Egawa Satoru, Onuma Hiroaki, Hashimoto Jun, Utagawa Kurando, Takahashi Takuya, Arai Yoshiyasu, Yoshii Toshitaka
Department of Orthopaedic Surgery, Institute of Science Tokyo, Tokyo, Japan.
Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5, Nishikawaguchi, Kawaguchi-shi, Saitama, 332-8558, Japan.
BMC Musculoskelet Disord. 2025 Jun 3;26(1):552. doi: 10.1186/s12891-025-08782-x.
The iliac crest bone graft (ICBG) has been traditionally used as the gold standard for anterior cervical discectomy and fusion (ACDF). However, the complication rate associated with harvesting the tricortical ICBG is significantly high. Thus, this study aimed to investigate the efficacy of the hydroxyapatite/collagen (HAp/Col) composite graft combined with an intervertebral cage in ACDF.
This was a retrospective study investigated 49 consecutive patients who underwent one- or two-level ACDF using the HAp/Col composite graft combined with an intervertebral cage at two institutions from March 2016 to January 2019. Clinical and radiological evaluations were performed before the surgeries and during the postoperative follow-up. Further, the outcomes of ACDF using the HAp/Col composite graft combined with the cage were compared with those of the tricortical ICBG without the cage.
The Japanese Orthopaedic Association (JOA) scores of the HAp/Col and ICBG groups at 2 years postoperatively improved significantly compared with those preoperatively. The two groups did not significantly differ in terms of the recovery rate based on the JOA scores at 2 years postoperatively. The fusion rates in the HAp/Col group (one-level, 95.7%; two-level, 92.0%) were comparable to those in ICBG group (one-level, 100%; two-level, 88.9%) at 2 years postoperatively. The surgical time was significantly shorter in the HAp/Col group (one-level, 113.2 min; two-level, 157.5 min) than in the ICBG group (one-level, 161.0 min; 2-level, 223.3 min) for both one- and two-level fusions. Intraoperative blood loss was significantly lower in the HAp/Col group than in the ICBG group in two-level fusion (HAp/Col, 34.1 g; ICBG, 215.4 g).
The HAp/Col composite graft with an intervertebral cage could be a safe and effective alternative scaffold to the conventional autologous iliac tricortical grafts in ACDF.
Not applicable.
传统上，髂嵴骨移植（ICBG）一直被用作颈椎前路椎间盘切除融合术（ACDF）的金标准。然而，获取三皮质ICBG相关的并发症发生率显著较高。因此，本研究旨在探讨羟基磷灰石/胶原蛋白（HAp/Col）复合移植材料联合椎间融合器在ACDF中的疗效。
这是一项回顾性研究，调查了2016年3月至2019年1月期间在两家机构接受使用HAp/Col复合移植材料联合椎间融合器进行单节段或双节段ACDF的49例连续患者。在手术前和术后随访期间进行了临床和影像学评估。此外，将使用HAp/Col复合移植材料联合椎间融合器的ACDF结果与未使用椎间融合器的三皮质ICBG的结果进行了比较。
术后2年，HAp/Col组和ICBG组的日本骨科学会（JOA）评分与术前相比均有显著改善。两组术后2年基于JOA评分的恢复率无显著差异。术后2年，HAp/Col组的融合率（单节段，95.7%；双节段，92.0%）与ICBG组（单节段，100%；双节段，88.9%）相当。对于单节段和双节段融合，HAp/Col组的手术时间（单节段，113.2分钟；双节段，157.5分钟）均显著短于ICBG组（单节段，161.0分钟；双节段，223.3分钟）。在双节段融合中，HAp/Col组的术中失血量显著低于ICBG组（HAp/Col组，34.1克；ICBG组，215.4克）。
在ACDF中，HAp/Col复合移植材料联合椎间融合器可能是传统自体髂骨三皮质移植的一种安全有效的替代支架。
不适用。
