TY - JOUR
T1 - Retrospective study of anterior interbody fusion rates and patient outcomes of using mineralized collagen and bone marrow aspirate in multilevel adult spinal deformity surgery
AU - Hostin, Richard
AU - O'Brien, Michael
AU - McCarthy, Ian
AU - Bess, Shay
AU - Gupta, Munish
AU - Klineberg, Eric
N1 - Publisher Copyright:
© 2013 Wolters Kluwer Health, Inc.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Design: Retrospective, single-center analysis of multilevel anterior fusion rates and health-related quality-of-life outcomes of mineralized collagen and bone marrow aspirate (BMA) in anterior interbody fusion cages for spine fusion surgery. Objective: To determine the ability and effectiveness of mineralized collagen and BMA to achieve multilevel anterior spinal fusion in adult spinal deformity patients when placed in carbon fiber reinforced polymer cages. Summary of Background Data: High rates of postoperative pain and nonunion can result from spine fusion procedures. Factors that affect the success of fusion include patient comorbidities, position of implant, and mechanical and biological deficiencies, as well as the choice of bone graft replacement. Methods: Analysis of radiographic images and health-related quality-of-life outcomes was performed for a consecutive series of 22 prospectively enrolled adult spinal deformity patients with 104 total anterior fusion levels. Fusions were graded by 3 blinded surgeons not involved in the operative procedure; each fusion was graded on a 1-4 scale based on fusion mass appearance. Levels with an average fusion grade of 1-2.4 were classified as fused; levels with an average grade >2.5 were classified as not fused. Results: The mean patient age was 51.5 years (range, 38-61) with 21 females. A total of 95% of anterior operative levels were graded as fused based on flexion/extension and full-length biplane radiographs at 1 year. Computed tomography grading showed a reduced fusion rate at 87% overall. There was a statistically significant improvement in the Oswestry Disability Index and Scoliosis Research Society 22-item questionnaire scores at 1 and 2 years after index surgery. Conclusions: Fusion rates in multilevel anterior spinal fusion using mineralized collagen and BMA are relatively low compared with fusion rates of 95% or more reported in the existing literature on long fusions with bone morphogenetic protein.
AB - Design: Retrospective, single-center analysis of multilevel anterior fusion rates and health-related quality-of-life outcomes of mineralized collagen and bone marrow aspirate (BMA) in anterior interbody fusion cages for spine fusion surgery. Objective: To determine the ability and effectiveness of mineralized collagen and BMA to achieve multilevel anterior spinal fusion in adult spinal deformity patients when placed in carbon fiber reinforced polymer cages. Summary of Background Data: High rates of postoperative pain and nonunion can result from spine fusion procedures. Factors that affect the success of fusion include patient comorbidities, position of implant, and mechanical and biological deficiencies, as well as the choice of bone graft replacement. Methods: Analysis of radiographic images and health-related quality-of-life outcomes was performed for a consecutive series of 22 prospectively enrolled adult spinal deformity patients with 104 total anterior fusion levels. Fusions were graded by 3 blinded surgeons not involved in the operative procedure; each fusion was graded on a 1-4 scale based on fusion mass appearance. Levels with an average fusion grade of 1-2.4 were classified as fused; levels with an average grade >2.5 were classified as not fused. Results: The mean patient age was 51.5 years (range, 38-61) with 21 females. A total of 95% of anterior operative levels were graded as fused based on flexion/extension and full-length biplane radiographs at 1 year. Computed tomography grading showed a reduced fusion rate at 87% overall. There was a statistically significant improvement in the Oswestry Disability Index and Scoliosis Research Society 22-item questionnaire scores at 1 and 2 years after index surgery. Conclusions: Fusion rates in multilevel anterior spinal fusion using mineralized collagen and BMA are relatively low compared with fusion rates of 95% or more reported in the existing literature on long fusions with bone morphogenetic protein.
KW - anterior interbody fusion
KW - bone marrow aspirate
KW - health-related quality of life
KW - mineralized collagen
UR - http://www.scopus.com/inward/record.url?scp=84992089418&partnerID=8YFLogxK
U2 - 10.1097/BSD.0b013e318292468f
DO - 10.1097/BSD.0b013e318292468f
M3 - Article
C2 - 27171663
AN - SCOPUS:84992089418
SN - 2380-0186
VL - 29
SP - E384-E388
JO - Clinical spine surgery
JF - Clinical spine surgery
IS - 8
ER -