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Efficacy of different bone volume expanders for augmenting lumbar fusions
1Department of Neurosurgery, The Albert Einstein College of Medicine, Bronx, NY 10461, USA. dch3@columbia.edu
Surgical Neurology
|December 7, 2007
Summary
Bone graft expanders like demineralized bone matrix (DBMs) and artificial substitutes (HA, B-TCP) effectively enhance lumbar fusions. These materials, used with autografts, show comparable fusion rates and outcomes in posterolateral spinal fusion procedures.
Area of Science:
- Spinal Surgery
- Orthopedic Research
- Biomaterials Science
Background:
- Posterolateral lumbar fusions utilize various bone volume expanders.
- Efficacy assessment focuses on fusion rates, complications, and patient outcomes.
Purpose of the Study:
- Review the efficacy of bone graft expanders in lumbar fusions.
- Evaluate allograft-based demineralized bone matrices (DBMs) and artificial bone graft substitutes.
Main Methods:
- Literature review of studies on noninstrumented and instrumented lumbar fusions.
- Analysis of fusion rates using dynamic X-ray and/or CT.
- Outcome assessment via Odom's criteria and various patient questionnaires.
Main Results:
- Comparable fusion rates and outcomes between instrumented and noninstrumented fusions.
- DBMs and beta-tricalcium phosphate (B-TCP) effectively supplement autograft fusions.
- Instrumentation may increase reoperation rates, operative time, blood loss, and cost.
Conclusions:
- Allograft-based DBMs and artificial bone substitutes (HA, B-TCP) effectively promote posterolateral lumbar fusions.
- These expanders enhance fusion when used as adjuncts to autografts.
