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Porous/Dense Composite Hydroxyapatite for Anterior Cervical Discectomy and Fusion.
MedLine Citation:
PMID:  23211531     Owner:  NLM     Status:  Publisher    
ABSTRACT: Study Design. A prospective analysisObjective. Our aim was to investigate the efficacy of new synthetic porous/dense composite hydroxyapatite (HA) for use in anterior cervical discectomy and fusion (ACDF).Summary of Background Data. Iliac crest bone graft (ICBG) has been traditionally used as the golden standard for ACDF. The significant complication rate associated with harvesting tricortical ICBG, however, has encouraged development of alternative graft substitutes.Methods. The morphology of the porous/dense HA was observed by scanning electron microscopy (SEM), and the in vitro compressive strength of the composite HA was measured. From April 2005, 51 consecutive patients underwent 81 levels of ACDF using the composite HA with percutaneously harvested trephine bone chips. Clinical and radiological evaluation was performed during the postoperative hospital stay and at follow-up. Furthermore, the outcomes in ACDF using the composite HA were compared with those using tricortical ICBG.Results. The SEM images demonstrated 100 - 300 mm pores (approximately 40% of porosity) in the porous layers of the HA. The compressive strength of the composite HA was 203.1±4.1MPa. In the clinical study, the demographic data of the patients were similar in HA and ICBG groups. The fusion rates in HA group were comparable to those in ICBG group. The cervical lordosis were enhanced postoperatively in both groups and well preserved at 2-year follow-up without significant differences between the groups. The intraoperative blood loss in HA group was significantly smaller than that in ICBG group. Donor site complications were found in 29.2% of the patients in ICBG group, whereas no donor site morbidity was found in HA group. No major collapse or fragmentation of the composite HA was found.Conclusion. The hybrid graft of composite HA and percutaneously harvested trephine chips seemed promising as a graft substitute for ACDF.
Toshitaka Yoshii; Masato Yuasa; Shinichi Sotome; Tsuyoshi Yamada; Kyohei Sakaki; Takashi Hirai; Takashi Taniyama; Hiroyuki Inose; Tsuyoshi Kato; Yoshiyasu Arai; Shigenori Kawabata; Shoji Tomizawa; Mitsuhiro Enomoto; Kenichi Shinomiya; Atsushi Okawa
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-3
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Section of Orthopaedic and Spinal Surgery, Graduate School, 2Section of Regenerative Therapeutics for Spine and Spinal Cord, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. 3Global Center of Excellence (GCOE) Program for International Research Center for Molecular Science in Tooth and Bone Disease, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan.
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