Comparison of Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative Spondylolisthesis
Study DesignProspective, cohort, non-inferiority study.PurposeThis study evaluated the clinical and radiological outcomes of interbody fusion using a combination of demineralized bone matrix (DBM) and hydroxyapatite (HA).Overview of LiteratureThe use of autografts remains a gold standard in lumbar i...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2017-10-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-11-706.pdf |
| _version_ | 1818340455629193216 |
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| author | Asrafi Rizki Gatam Luthfi Gatam Singkat Dohar Lumban Tobing |
| author_facet | Asrafi Rizki Gatam Luthfi Gatam Singkat Dohar Lumban Tobing |
| author_sort | Asrafi Rizki Gatam |
| collection | DOAJ |
| description | Study DesignProspective, cohort, non-inferiority study.PurposeThis study evaluated the clinical and radiological outcomes of interbody fusion using a combination of demineralized bone matrix (DBM) and hydroxyapatite (HA).Overview of LiteratureThe use of autografts remains a gold standard in lumbar interbody fusion, but the limited availability and donor site morbidity encourages the use of bone substitutes. In addition to autografts, a combination of HA and DBM is being increasingly use for lumbar interbody fusion. However, there are no data on the clinical and radiological outcomes of this procedure.MethodsWe examined 35 patients with lumbar degenerative spondylolisthesis who underwent transforaminal interbody fusion. Autografts were used in 18 patients, and 17 patients received a combination of HA and DBM. Clinical outcomes were evaluated using the visual analog scale (VAS) for back and leg pain, Oswestry disability index (ODI), and Japanese Orthopaedic Association (JOA) scores at 3, 6, and 12 months postoperatively. Fusion was evaluated using computed tomography images obtained at 12 months postoperatively.ResultsThe mean ODI, JOA, and back and leg pain VAS scores increased significantly in both groups. However, the VAS, JOA, and ODI scores did not differ significantly between the two groups (p=0.599, p=0.543, and p=0.780, respectively). The fusion rates at 1 year postoperatively were 77.8% and 76.5% in the autograft and HA+DBM groups, respectively (p=0.99).ConclusionsThe clinical and radiological outcomes of using a combination of HA and DBM in lumbar interbody fusion were not inferior to those of using autografts. A combination of HA and DBM can be considered as an alternative in patients with lumbar degenerative spondylolisthesis requiring surgery. |
| first_indexed | 2024-12-13T15:43:10Z |
| format | Article |
| id | doaj.art-ba7ab68da7dd44bfab1979e66922ace4 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-13T15:43:10Z |
| publishDate | 2017-10-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-ba7ab68da7dd44bfab1979e66922ace42022-12-21T23:39:47ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462017-10-0111570671410.4184/asj.2017.11.5.706278Comparison of Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative SpondylolisthesisAsrafi Rizki Gatam0Luthfi Gatam1Singkat Dohar Lumban Tobing2Department of Orthopaedic and Traumatology, Fatmawati General Hospital, South Jakarta, Indonesia.Department of Orthopaedic and Traumatology, Fatmawati General Hospital, South Jakarta, Indonesia.Department of Orthopaedic and Traumatology, Cipto Mangunkusumo National Central Hospital and Faculty of Medicine University of Indonesia, Central Jakarta, Indonesia.Study DesignProspective, cohort, non-inferiority study.PurposeThis study evaluated the clinical and radiological outcomes of interbody fusion using a combination of demineralized bone matrix (DBM) and hydroxyapatite (HA).Overview of LiteratureThe use of autografts remains a gold standard in lumbar interbody fusion, but the limited availability and donor site morbidity encourages the use of bone substitutes. In addition to autografts, a combination of HA and DBM is being increasingly use for lumbar interbody fusion. However, there are no data on the clinical and radiological outcomes of this procedure.MethodsWe examined 35 patients with lumbar degenerative spondylolisthesis who underwent transforaminal interbody fusion. Autografts were used in 18 patients, and 17 patients received a combination of HA and DBM. Clinical outcomes were evaluated using the visual analog scale (VAS) for back and leg pain, Oswestry disability index (ODI), and Japanese Orthopaedic Association (JOA) scores at 3, 6, and 12 months postoperatively. Fusion was evaluated using computed tomography images obtained at 12 months postoperatively.ResultsThe mean ODI, JOA, and back and leg pain VAS scores increased significantly in both groups. However, the VAS, JOA, and ODI scores did not differ significantly between the two groups (p=0.599, p=0.543, and p=0.780, respectively). The fusion rates at 1 year postoperatively were 77.8% and 76.5% in the autograft and HA+DBM groups, respectively (p=0.99).ConclusionsThe clinical and radiological outcomes of using a combination of HA and DBM in lumbar interbody fusion were not inferior to those of using autografts. A combination of HA and DBM can be considered as an alternative in patients with lumbar degenerative spondylolisthesis requiring surgery.http://www.asianspinejournal.org/upload/pdf/asj-11-706.pdfLumbarSpine fusionBone matrixHydroxyapatiteLumbar degenerative spondylolisthesis |
| spellingShingle | Asrafi Rizki Gatam Luthfi Gatam Singkat Dohar Lumban Tobing Comparison of Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative Spondylolisthesis Asian Spine Journal Lumbar Spine fusion Bone matrix Hydroxyapatite Lumbar degenerative spondylolisthesis |
| title | Comparison of Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative Spondylolisthesis |
| title_full | Comparison of Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative Spondylolisthesis |
| title_fullStr | Comparison of Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative Spondylolisthesis |
| title_full_unstemmed | Comparison of Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative Spondylolisthesis |
| title_short | Comparison of Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative Spondylolisthesis |
| title_sort | comparison of clinical and radiological outcomes of lumbar interbody fusion using a combination of hydroxyapatite and demineralized bone matrix and autografts for lumbar degenerative spondylolisthesis |
| topic | Lumbar Spine fusion Bone matrix Hydroxyapatite Lumbar degenerative spondylolisthesis |
| url | http://www.asianspinejournal.org/upload/pdf/asj-11-706.pdf |
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