Biology of Spine Fusion and Application of Osteobiologics in Spine Surgery

2017 ◽  
pp. 229-247 ◽  
Author(s):  
Sachin Gupta ◽  
Vivek Mohan ◽  
Munish C. Gupta
Keyword(s):  
Spine Surgery ◽  
Spine Fusion

scholarly journals Incidence and cost of perioperative red blood cell transfusion for elective spine fusion in a high-volume center for spine surgery

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Giuseppe Ristagno ◽  
Simonetta Beluffi ◽  
Guido Menasce ◽  
Dario Tanzi ◽  
Juan C. Pastore ◽  
...  
Keyword(s):  
Blood Cell ◽  
Spine Surgery ◽  
Red Blood Cell ◽  
High Volume ◽  
Spine Fusion ◽  
Red Blood Cell Transfusion ◽  
High Volume Center

scholarly journals A history of spine surgery predicts a poor outcome after hip arthroscopy

2019 ◽  
Author(s):  
Jacob D Feingold ◽  
Braiden Heaps ◽  
Sava Turcan ◽  
Erica Swartwout ◽  
Anil Ranawat
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Hip Arthroscopy ◽  
Spine Fusion ◽  
Harris Hip Score ◽  
Lumbar Spine Surgery ◽  
P Value ◽  
Decompression Surgery ◽  
Outcome Score ◽  
The Difference

Abstract This study compared patient reported outcomes scores (PROMs) between patients undergoing hip arthroscopy who have and have not had previous lumbar spine surgery. We aimed to determine if prior spine surgery impacts the outcome of hip arthroscopy. Data were prospectively collected and retrospectively reviewed in patients who underwent hip arthroscopy between 2010 and 2017. Twenty cases were identified for analysis and matched to a control group. Four PROMs were collected pre-operatively and between 6 months and 2 years post-operatively (mean 16.2 months): Modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports (HOS-Sports) and the 33-item International Hip Outcome Tool (iHOT-33). Patients with previous spine surgery reported significantly worse (P-value <0.001) post-operative scores on all PROMs and smaller net changes on all PROMs with the difference on the mHHS (P-value 0.007), HOS-Sport (P-value 0.009) and iHOT-33 (P-value 0.007) being significant. Subsequent analyses revealed that the type of spine surgery matters. Patients with a spine fusion reported worse post-operative scores on all PROMs compared with patients with a spine decompression surgery with the difference on the mHHS (P-value 0.001), HOS-ADL (P-value 0.011) and HOS-Sport (P-value 0.035) being significant. Overall, patients with prior decompression surgery experienced considerable improvements from hip arthroscopy whereas patients with a prior spine fusion reported poor post-operative outcomes. Given these results, it is vital that hip preservation surgeons understand the impact of the lumbar spine on the outcome of hip arthroscopy.

scholarly journals Improving the Clinical Evidence of Bone Graft Substitute Technology in Lumbar Spine Surgery

2012 ◽  
Vol 2 (4) ◽  
pp. 239-248 ◽  
Author(s):  
Wellington K. Hsu ◽  
M. S. Nickoli ◽  
J. C. Wang ◽  
J. R. Lieberman ◽  
H. S. An ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Bone Graft ◽  
Spine Surgery ◽  
Clinical Evidence ◽  
Bone Graft Substitute ◽  
Spine Fusion ◽  
Lumbar Spine Surgery ◽  
Lumbar Spine Fusion ◽  
Clinical Literature ◽  
Bone Graft Substitutes

Bone graft substitutes have been used routinely for spine fusion for decades, yet clinical evidence establishing comparative data remains sparse. With recent scrutiny paid to the outcomes, complications, and costs associated with osteobiologics, a need to improve available data guiding efficacious use exists. We review the currently available clinical literature, studying the outcomes of various biologics in posterolateral lumbar spine fusion, and establish the need for a multicenter, independent osteobiologics registry.

scholarly journals The Utility of Allograft Mesenchymal Stem Cells for Spine Fusion: A Literature Review

2012 ◽  
Vol 2 (2) ◽  
pp. 109-114 ◽  
Author(s):  
Daniel Lubelski ◽  
Kalil G. Abdullah ◽  
Edward C. Benzel ◽  
Thomas E. Mroz
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Spine Surgery ◽  
Adverse Outcomes ◽  
Spine Fusion ◽  
Alternative Methods ◽  
Osteogenic Potential ◽  
Iliac Crest Bone Graft ◽  
In Vivo Models ◽  
Graft Harvest

More than 50% of patients complain of postoperative donor site morbidity following iliac crest bone graft harvest, and recent discoveries have identified adverse outcomes following bone morphogenetic protein use in spine fusion. This has led the spine community to turn toward alternative methods to promote fusion following spine surgery. The present article reviews numerous studies that have shown the osteogenic potential of mesenchymal stem cells (MSCs). MSCs have been used with both in vitro and in vivo models and have involved animal studies ranging from rats to macaque monkeys to successfully induce bone regeneration in lesions of the tibia and spine. There is no fear of graft rejection, as there may be with other allograft materials, because neither undifferentiated nor differentiated MSCs elicit lymphocyte response when transplanted; they tend to alter the cytokine profile to an anti-inflammatory state. Early clinical trials are underway with various commercially available MSC formulations. Although there is much enthusiasm, it is integral that the spine surgery community carefully evaluate the use of MSCs in spine fusion through well-designed and executed studies to determine the efficacy and safety profiles in spine surgery patients.

Spinal surgery following organ transplantation

2011 ◽  
Vol 14 (6) ◽  
pp. 779-784 ◽  
Author(s):  
Kashif A. Shaikh ◽  
Gregory M. Helbig ◽  
Scott A. Shapiro ◽  
Mitesh V. Shah ◽  
Saad A. Khairi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Immunosuppressive Therapy ◽  
Organ Transplantation ◽  
Spine Surgery ◽  
Organ Transplant ◽  
Spine Fusion ◽  
Solid Organ ◽  
Organ Transplants ◽  
Fusion Surgery

Object Organ transplantation for renal, liver, cardiac, and pulmonary failure has become more common in recent years, and patients are living longer as a result of improved organ preservation methods, immunosuppressive regimens, and general posttransplant care. Some of these patients undergo spine fusion surgery following organ transplantation, and there is little available information concerning outcomes. The authors report on their experience with and the outcomes of spine fusion in this rare and unique immunosuppressed patient group. Methods Using the Current Procedural Terminology and ICD-9 codes for solid organ transplants, bone marrow transplantations (BMTs), and spine fusion surgeries, the authors searched their patient database between 1997 and 2008. Data points of interest included primary diagnosis, type of organ transplant, immunosuppressant drug therapy, complications from spine surgery, and radiographic analysis of spine fusion. Spine fusion was assessed with CT or radiography at the latest follow-up. Results The database search results revealed 5999 patients who underwent heart, lung, liver, kidney, pancreas, intestine, or bone marrow transplant between 1997 and 2008. Eighteen of the 5999 patients underwent a spine fusion surgery while receiving immunosuppressive therapy. Organ transplants included kidney, liver, heart, pancreas, and allogenic BMT. There were 3 deaths unrelated to spine fusion within 1 year of the surgery and 1 death immediately after spine surgery. Graft-versus-host disease developed in 1 patient when prednisone was stopped prior to the spine surgery. Thirteen patients underwent follow-up radiographic imaging at an average of 25 months after spine surgery; 12 demonstrated radiographic fusion. Conclusions The results suggest that spine fusion rates are adequate despite immunosuppressive therapy in patients undergoing spinal fusion after transplant procedures. The data also illustrate the high morbidity and mortality rates found in the organ transplant patient population.

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