Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages
Abstract Purpose To investigate the efficacy and safety of allograft and hydroxyapatite (HA) as substitutes for autograft in anterior cervical discectomy and fusion (ACDF). Methods In this study, 49 patients (80 segments) treated with ACDF were included and allocated into three groups [group A, auto...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-02-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02257-0 |
| _version_ | 1797999263322472448 |
|---|---|
| author | Changsheng Yang Wentao Zhuo Qingchu Li Caiqiang Huang Huibo Yan Dadi Jin |
| author_facet | Changsheng Yang Wentao Zhuo Qingchu Li Caiqiang Huang Huibo Yan Dadi Jin |
| author_sort | Changsheng Yang |
| collection | DOAJ |
| description | Abstract Purpose To investigate the efficacy and safety of allograft and hydroxyapatite (HA) as substitutes for autograft in anterior cervical discectomy and fusion (ACDF). Methods In this study, 49 patients (80 segments) treated with ACDF were included and allocated into three groups [group A, autogenous iliac bone, n = 18; group B, allogeneic bone, n = 16; group C, HA, n = 15]. The clinical efficacy and fusion status were compared among each group. Complications were recorded in detail, and the Bazaz classification and Voice Handicap Index-10 (VHI-10) were used to detect dysphagia and dysphonia. Results Patients exhibited similar clinical efficacy among the groups during the final follow-up. All patients in groups A and B achieved fusion compared to only 73.3% of patients in group C. Groups A and B had similar fusion score, both of which greater than that of group C. No cage subsidence was observed in group A; however, 6.3% of patients in group B and 53.3% in group C had cage subsidence. Two patients in group A (11.1%) had persistent pain at the donor site. One patient in group B had dysphagia and dysphonia (6.3%), while one patient in group C had dysphonia (6.7%). Conclusion In ACDF, the autogenous iliac bone was the most ideal bone graft. The allogeneic bone was an acceptable substitute but risked cage subsidence and dysphagia. HA had a much lower fusion rate and a high risk of cage subsidence. Better substitutes should be further explored for ACDF. |
| first_indexed | 2024-04-11T11:01:51Z |
| format | Article |
| id | doaj.art-5be01ddc346040f0930204099a4f47b9 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T11:01:51Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-5be01ddc346040f0930204099a4f47b92022-12-22T04:28:35ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-02-0116111110.1186/s13018-021-02257-0Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cagesChangsheng Yang0Wentao Zhuo1Qingchu Li2Caiqiang Huang3Huibo Yan4Dadi Jin5Department of Orthopedics, Academy of Orthopedics of Guangdong Province, The Third Affiliated Hospital of Southern Medical UniversityDepartment of Orthopedics, Academy of Orthopedics of Guangdong Province, The Third Affiliated Hospital of Southern Medical UniversityDepartment of Orthopedics, Academy of Orthopedics of Guangdong Province, The Third Affiliated Hospital of Southern Medical UniversityDepartment of Orthopedics, Academy of Orthopedics of Guangdong Province, The Third Affiliated Hospital of Southern Medical UniversityDepartment of Orthopedics, Academy of Orthopedics of Guangdong Province, The Third Affiliated Hospital of Southern Medical UniversityDepartment of Orthopedics, Academy of Orthopedics of Guangdong Province, The Third Affiliated Hospital of Southern Medical UniversityAbstract Purpose To investigate the efficacy and safety of allograft and hydroxyapatite (HA) as substitutes for autograft in anterior cervical discectomy and fusion (ACDF). Methods In this study, 49 patients (80 segments) treated with ACDF were included and allocated into three groups [group A, autogenous iliac bone, n = 18; group B, allogeneic bone, n = 16; group C, HA, n = 15]. The clinical efficacy and fusion status were compared among each group. Complications were recorded in detail, and the Bazaz classification and Voice Handicap Index-10 (VHI-10) were used to detect dysphagia and dysphonia. Results Patients exhibited similar clinical efficacy among the groups during the final follow-up. All patients in groups A and B achieved fusion compared to only 73.3% of patients in group C. Groups A and B had similar fusion score, both of which greater than that of group C. No cage subsidence was observed in group A; however, 6.3% of patients in group B and 53.3% in group C had cage subsidence. Two patients in group A (11.1%) had persistent pain at the donor site. One patient in group B had dysphagia and dysphonia (6.3%), while one patient in group C had dysphonia (6.7%). Conclusion In ACDF, the autogenous iliac bone was the most ideal bone graft. The allogeneic bone was an acceptable substitute but risked cage subsidence and dysphagia. HA had a much lower fusion rate and a high risk of cage subsidence. Better substitutes should be further explored for ACDF.https://doi.org/10.1186/s13018-021-02257-0Anterior cervical discectomyFusionBone graftAllograftHydroxyapatite |
| spellingShingle | Changsheng Yang Wentao Zhuo Qingchu Li Caiqiang Huang Huibo Yan Dadi Jin Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages Journal of Orthopaedic Surgery and Research Anterior cervical discectomy Fusion Bone graft Allograft Hydroxyapatite |
| title | Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages |
| title_full | Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages |
| title_fullStr | Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages |
| title_full_unstemmed | Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages |
| title_short | Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages |
| title_sort | preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self locking standalone cages |
| topic | Anterior cervical discectomy Fusion Bone graft Allograft Hydroxyapatite |
| url | https://doi.org/10.1186/s13018-021-02257-0 |
| work_keys_str_mv | AT changshengyang preliminaryoutcomesofallograftandhydroxyapatiteassubstitutesforautograftinanteriorcervicaldiscectomyandfusionwithselflockingstandalonecages AT wentaozhuo preliminaryoutcomesofallograftandhydroxyapatiteassubstitutesforautograftinanteriorcervicaldiscectomyandfusionwithselflockingstandalonecages AT qingchuli preliminaryoutcomesofallograftandhydroxyapatiteassubstitutesforautograftinanteriorcervicaldiscectomyandfusionwithselflockingstandalonecages AT caiqianghuang preliminaryoutcomesofallograftandhydroxyapatiteassubstitutesforautograftinanteriorcervicaldiscectomyandfusionwithselflockingstandalonecages AT huiboyan preliminaryoutcomesofallograftandhydroxyapatiteassubstitutesforautograftinanteriorcervicaldiscectomyandfusionwithselflockingstandalonecages AT dadijin preliminaryoutcomesofallograftandhydroxyapatiteassubstitutesforautograftinanteriorcervicaldiscectomyandfusionwithselflockingstandalonecages |