The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion
Objectives: The objectives of our study were to compare the fusion rates and surgical outcomes of lumbar fusion surgery based on the (1) type of demineralized bone matrix (DBM) carrier allograft, (2) the presence/absence of a carrier, and (3) the presence of bone fibers in DBM. Methods: Patients &...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=2;spage=194;epage=200;aulast=Heard |
| _version_ | 1827894921671999488 |
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| author | Jeremy C Heard Yunsoo Lee Mark J Lambrechts Emily Berthiaume Nicholas D D'Antonio John Bodnar John Paulik John J Mangan Jose A Canseco Mark F Kurd I David Kaye Alexander R Vaccaro Christopher K Kepler Gregory D Schroeder Alan S Hilibrand |
| author_facet | Jeremy C Heard Yunsoo Lee Mark J Lambrechts Emily Berthiaume Nicholas D D'Antonio John Bodnar John Paulik John J Mangan Jose A Canseco Mark F Kurd I David Kaye Alexander R Vaccaro Christopher K Kepler Gregory D Schroeder Alan S Hilibrand |
| author_sort | Jeremy C Heard |
| collection | DOAJ |
| description | Objectives: The objectives of our study were to compare the fusion rates and surgical outcomes of lumbar fusion surgery based on the (1) type of demineralized bone matrix (DBM) carrier allograft, (2) the presence/absence of a carrier, and (3) the presence of bone fibers in DBM.
Methods: Patients >18 years of age who underwent single-level posterolateral decompression and fusion (PLDF) between L3 and L5 between 2014 and 2021 were retrospectively identified. We assessed bone grafts based on carrier type (no carrier, sodium hyaluronate carrier, and glycerol carrier) and the presence of bone fibers. Fusion status was determined based on a radiographic assessment of bony bridging, screw loosening, or change in segmental lordosis >5°. Analyses were performed to assess fusion rates and surgical outcomes.
Results: Fifty-four patients were given DBM with a hyaluronate carrier, 75 had a glycerol carrier, and 94 patients were given DBM without a carrier. DBM carrier type, bone fibers, and carrier presence had no impact on 90-day readmission rates (P = 0.195, P = 0.099, and P = 1.000, respectively) or surgical readmissions (P = 0.562, P = 0.248, and P = 0.640, respectively). Multivariable logistic regression analysis found that type of carrier, presence of fibers (odds ratio [OR] = 1.106 [0.524–2.456], P = 0.797), and presence of a carrier (OR = 0.701 [0.370–1.327], P = 0.274) were also not significantly associated with successful fusion likelihood.
Conclusion: Our study found no significant differences between DBM containing glycerol, sodium hyaluronate, or no carrier regarding fusion rates or surgical outcomes after single-level PLDF. Bone particulates versus bone fibers also had no significant differences regarding the likelihood of bony fusion. |
| first_indexed | 2024-03-12T22:14:26Z |
| format | Article |
| id | doaj.art-d6f92bc195604e5da39161330f7ef6dc |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-03-12T22:14:26Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-d6f92bc195604e5da39161330f7ef6dc2023-07-23T11:24:02ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372023-01-0114219420010.4103/jcvjs.jcvjs_45_23The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusionJeremy C HeardYunsoo LeeMark J LambrechtsEmily BerthiaumeNicholas D D'AntonioJohn BodnarJohn PaulikJohn J ManganJose A CansecoMark F KurdI David KayeAlexander R VaccaroChristopher K KeplerGregory D SchroederAlan S HilibrandObjectives: The objectives of our study were to compare the fusion rates and surgical outcomes of lumbar fusion surgery based on the (1) type of demineralized bone matrix (DBM) carrier allograft, (2) the presence/absence of a carrier, and (3) the presence of bone fibers in DBM. Methods: Patients >18 years of age who underwent single-level posterolateral decompression and fusion (PLDF) between L3 and L5 between 2014 and 2021 were retrospectively identified. We assessed bone grafts based on carrier type (no carrier, sodium hyaluronate carrier, and glycerol carrier) and the presence of bone fibers. Fusion status was determined based on a radiographic assessment of bony bridging, screw loosening, or change in segmental lordosis >5°. Analyses were performed to assess fusion rates and surgical outcomes. Results: Fifty-four patients were given DBM with a hyaluronate carrier, 75 had a glycerol carrier, and 94 patients were given DBM without a carrier. DBM carrier type, bone fibers, and carrier presence had no impact on 90-day readmission rates (P = 0.195, P = 0.099, and P = 1.000, respectively) or surgical readmissions (P = 0.562, P = 0.248, and P = 0.640, respectively). Multivariable logistic regression analysis found that type of carrier, presence of fibers (odds ratio [OR] = 1.106 [0.524–2.456], P = 0.797), and presence of a carrier (OR = 0.701 [0.370–1.327], P = 0.274) were also not significantly associated with successful fusion likelihood. Conclusion: Our study found no significant differences between DBM containing glycerol, sodium hyaluronate, or no carrier regarding fusion rates or surgical outcomes after single-level PLDF. Bone particulates versus bone fibers also had no significant differences regarding the likelihood of bony fusion.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=2;spage=194;epage=200;aulast=Heardbone matrixlumbar fusionpseudarthrosissurgical outcomes |
| spellingShingle | Jeremy C Heard Yunsoo Lee Mark J Lambrechts Emily Berthiaume Nicholas D D'Antonio John Bodnar John Paulik John J Mangan Jose A Canseco Mark F Kurd I David Kaye Alexander R Vaccaro Christopher K Kepler Gregory D Schroeder Alan S Hilibrand The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion Journal of Craniovertebral Junction and Spine bone matrix lumbar fusion pseudarthrosis surgical outcomes |
| title | The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion |
| title_full | The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion |
| title_fullStr | The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion |
| title_full_unstemmed | The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion |
| title_short | The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion |
| title_sort | impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion |
| topic | bone matrix lumbar fusion pseudarthrosis surgical outcomes |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=2;spage=194;epage=200;aulast=Heard |
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