scholarly journals Anterior Debridement, Bone Grafting And Fixation For Cervical Spine Tuberculosis :Iliac Bone Graft Versus Structural Manubrium Graft

2021 ◽  
Author(s):  
Shuang Xu ◽  
Yueming Song ◽  
Qing Wang ◽  
Gaoju Wang ◽  
Jin Yang ◽  
...  
Keyword(s):  
Bone Graft ◽  
Donor Site ◽  
Spinal Tuberculosis ◽  
Bone Grafts ◽  
Iliac Bone ◽  
Graft Material ◽  
Anterior Debridement ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background The purpose of this retrospective study was to compare the clinical outcomes of anterior surgical management for cervical spinal tuberculosis by iliac bone grafts versus structural manubrium graft.Methods From January 2009 to September 2018, 23 patients with cervical spinal tuberculosis were treated with anterior debridement,autogenous structural bone graft and fixation at our spinal department. The patients were divided into 2 groups according to the different graft material,including iliac crest bone grafts in group A, structural manubrium grafts in group B. The clinical and radiographic results for the 2 groups were analyzed and compared. Results The mean duration of follow-up was 24 months. Bony fusion was achieved in all cases without failure of internal fixation. There were no significant differences between groups regarding the the operation time,blood loss,fusion time,neurological outcomes,and postoperative local Cobb angle (P>.05).However,the donor site complication rate of Group A was more than that of Group B. Postoperative ambulation time in group A was later than that of group B.The mean visual analog scale (VAS) for donor-site pain in group A was higher than group B at a week after surgery (P < 0.05).However,there was no significant difference between the 2 groups at last visit (P>.05).Conclusion Both iliac bone grafts and sternal manubrium grafts can effectively reconstruct anterior column defects in anterior surgery. However,structural sternal manubrium autografts has less complications associated with donor site morbidities than that of iliac bone.

Autogenous Bone Graft Versus Bovine Bone Graft in Association With Platelet-Rich Plasma for the Reconstruction of Alveolar Clefts: A Pilot Study

2018 ◽  
Vol 56 (1) ◽  
pp. 134-140 ◽  
Author(s):  
Bruno Torres Bezerra ◽  
John Nadson Andrade Pinho ◽  
Fabrício Eneas Diniz Figueiredo ◽  
José Renato Moraes Carvalho Barreto Brandão ◽  
Lucas Celestino Guerzet Ayres ◽  
...  
Keyword(s):  
Bone Graft ◽  
Platelet Rich Plasma ◽  
Bone Grafts ◽  
Autogenous Bone ◽  
Bovine Bone ◽  
Alveolar Bone Grafting ◽  
Significant Difference ◽  
Group A ◽  
Autologous Bone ◽  
Group B

Objective: To compare the outcomes of 2 different bone graft materials: autogenous bone grafts from mandibular symphysis and bovine bone grafts associated with platelet-rich plasma (PRP). Methods: Twenty individuals met the inclusion criteria and accepted to participate in the study. Group A patients underwent alveolar bone grafting using autologous bone and group B patients using a bovine bone graft associated with PRP. Cone beam computed tomography scans were taken and reconstructed 3-dimensionally for all patients preoperatively and 1 year postoperatively. Results: A significant reduction was detected for area and volume within group A and group B. Between groups, no significant difference was found for area or volume. Conclusions: Bovine grafts associated with PRP are a good option for the reconstruction of alveolar clefts and provide good results such as autologous bone grafts.

scholarly journals Comparison between bundled multi-segment rib graft and titanium mesh bone graft in the treatment of thoracic and lumbar spinal tuberculosis

2019 ◽  
Author(s):  
Yifan Wang ◽  
Shiyuan Shi ◽  
Qi Zheng ◽  
Mingfeng Zheng ◽  
Yanghui Jin
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Spinal Tuberculosis ◽  
Operation Time ◽  
Titanium Mesh ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Lumbar Spinal

Abstract Background: To investigate the two different methods including bone grafting with bundled multi-segment ribs and titanium mesh bone grafting through posterior approach in patients with thoracic and lumbar spinal tuberculosis. Methods: 38 patients with thoracic spinal tuberculosis in our hospital were divided into group A (19 cases of titanium mesh bone grafting) and group B (19 cases of bone grafting with bundled multi-segment ribs). The transverse costal process approach was firstly initiated, then the necrotic tissue of tuberculosis lesions was removed thoroughly. Finally, titanium mesh bone grafting and bone grafting with bundled multi-segment ribs was applied, respectively. Results: The data demonstrated that 12 to 24 months of follow-up revealed that the operation time of Titanium mesh bone grafting in group A was 21.2+2.3 min, and that of bundled rib bone grafting in group B was 7.2+2.4 min. Compared to group A, the time in group B was significantly shorter. The amount of bleeding in group A not distinct from that in group B. There was no significant difference in Cobb angle. The fusion time in the two groups was similar. There was no significant difference in Oswestry dysfunction index between the two groups at the last follow-up. Conclusions: Bone grafting with bundled multi-segment ribs could stable the function quickly after thoracic tuberculosis lesion clearance, indicating as an alternative and development prospects of bone graft strategy.

Clinical Results Of A Lamina With Spinous Process And An Iliac Graft As Bone Grafts In The Surgical Treatment Of Single-Segment Lumbar Pyogenic Discitis: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Weiyang Zhong ◽  
Xinjie Liang ◽  
Xiaolin Wang ◽  
Ke Tang ◽  
Tianji Huang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Spinous Process ◽  
Bone Grafts ◽  
Clinical Results ◽  
Single Segment ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Segmental Angle

Abstract Background: A retrospective study investigated and compared the results of a lamina withspinous process (LSP) and an iliac graft (IG) as bone grafts in single-segment lumbar pyogenic discitis (LPD) through one-stage-posterior-only approach with radical debridement and internal instrumentation.Methods: Data from 37 patients were reviewed. A LSP was placed in 17 patients (group A), and an IG was implemented in 20 patients (group B). The surgery time, surgery hemorrhage, hospital stay, drainage, and follow-up (FU) were reviewed. The visual analogue scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, segmental angle, intervertebral height and bony fusion time were compared preoperatively and at the final FU.Results: All patients were followed-up for a mean of 27.94±2.35 months in group A and 30.29±1.89 months in group B, without a difference. The mean age was younger in group A than in group B (P<0.05). The surgery time, surgery hemorrhage, and hospitalization cost were lower in group A than in group B (P<0.05), except for the hospital stay and drainage time. Fever occurred in 10 patients in group A and 12 patients in group B. The ESR, CRP level, and VAS and ODI scores were significantly decreased, and there were no significant differences between the groups at the final FU. The distribution of bacterial agents in blood culture was 1 case of Aerobacter cloacae, 2 of Staphylococcus aureus, 2 of Escherichia coli, and 1 of Streptococcus viridis in group A and 1 of S. aureus，1 of Staphylococcus warneri and 2 of Klebsiella pneumoniae in group B. Pyogenic infection was observed in the pathological findings of all patients. No significant difference was found in the mean segmental angle or mean intervertebral height preoperation and at the final FU between the groups.Conclusion: The use of LSP as a new bone graft is reliable, safe, and effective for surgical management for the LPD while surgery is proposed as a good management strategy for LPD in carefully selected patients.

scholarly journals Comparison of the inner side and two-sided approaches for iliac crest bone graft harvesting for pediatric pelvic osteotomy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xin Chen ◽  
Kai Chen ◽  
Yuxi Su
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Pelvic Osteotomy ◽  
Outer Side ◽  
Iliac Crest Bone Graft ◽  
Exposure Group ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Clinical Records

Abstract Background The iliac crest is one of the most used bone graft sources. In this study, we aimed to identify the effects of inner side and two-sided approaches for iliac crest bone harvesting on post-surgery ilium growth in children. Materials and methods We retrospectively analyzed 47 patients who underwent pelvic osteotomy and iliac crest bone graft (ICBG) procedures from January 2015 to September 2018. The patients were divided into an inner table ilium exposure group (group A) and the inner-outer table ilium exposure group (group B) and were followed up with radiography in postoperative months 1, 3, 6, and 12, and the growth areas were measured using PACS software. Complications such as damage to the arteries or nerves, ureteral injury, gastrointestinal hernia, ileus, abnormal cosmetic appearance, sensory disturbances, and functional limitations were recorded based on clinical records. Results There were 22 patients aged 5.3±1.5 years in group A and 25 patients aged 5.9±1.8 years in group B. There were no significant differences in demographics between the two groups, or in growth in the first month. However, bone graft growth at months 3, 6, and 12 was significantly better in group A than in group B. There was no significant difference in complications between the two groups. Conclusion Exposure of only the inner table of the ilium resulted in faster recovery of the bone defect than two-sided exposure in pelvic osteotomy. Therefore, we suggest protecting the outer side of the ilium during surgery. Level of evidence Level III

scholarly journals Comparison of single posterior debridement, bone grafting, and instrumentation with single anterior debridement, bone grafting, and instrumentation in treatment of thoracic spinal tuberculosis

2019 ◽  
Author(s):  
Yongchun Zhou ◽  
Weiwei Li ◽  
Liqun Gong ◽  
Jiao Zhou ◽  
Jing Luo
Keyword(s):  
Bone Grafting ◽  
Spinal Tuberculosis ◽  
Operation Time ◽  
Anterior Debridement ◽  
Thoracic Spinal ◽  
Group A ◽  
Group B ◽  
Posterior Debridement ◽  
Thoracic Spinal Tuberculosis

Abstract Objective To explore the clinical effect of single posterior debridement, bone grafting, and instrumentation and single anterior debridement, bone grafting and instrumentation in the treatment of thoracic spinal tuberculosis of adult patients. Methods: A retrospective analysis was made by involving 38 adult patients with thoracic spinal tuberculosis from between June 2013 and December 2015. Of the 38 patients, 21 patients were categorized in single anterior approach group and underwent single posterior debridement, bone grafting, and instrumentation (Group A). The remaining 17 patients were classified in single posterior approaches group (Group B), which received single posterior debridement, bone grafting and instrumentation. Clinical manifestations, laboratory and imaging results of the two groups were analyzed subsequently. Results: All patients were followed up for 23.9 ± 3.8 m (range, 19–36 m). Bony fusion was achieved in all bone grafts. The operation time and intraoperative blood loss in group B were significantly less than those in group A (P<0.05). The VAS scores, ESR, and CRP levels 6 weeks after operation and at the final follow-up were significantly lower than the preoperative levels (P<0.05). At the last follow-up, ASIA improvement no significant difference between groups (P>0.05). Furthermore, the postoperative and final-follow-up kyphosis angles in group B were both significantly smaller than those in group A (P<0.05). Group A had a postoperative angle correction rate smaller than group B, and its postoperative angle loss was greater than group B’s (P<0.05). Conclusion: Single posterior debridement, bone grafting, and instrumentation can achieve similar curative effect as single anterior debridement, bone grafting and instrumentation in the treatment of thoracic spinal tuberculosis, but also accompanied by additional advantages of shorter operation time and less bleeding .

scholarly journals Spinous Process Combined with a Titanium Mesh Cage as a Bone Graft in the Stability Reconstruction of Lumbar or Lumbosacral Spinal Tuberculosis

2021 ◽  
Author(s):  
Hongqi Zhang ◽  
Lige Xiao ◽  
mingxing Tang ◽  
Guanteng Yang
Keyword(s):  
Operative Time ◽  
Spinous Process ◽  
Spinal Tuberculosis ◽  
Pedicle Screws ◽  
Titanium Mesh ◽  
Bony Fusion ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Posterior Debridement

Abstract Background. To investigate the clinical efficacy of one-stage posterior debridement using the spinous process (SP) combined with titanium mesh cages (TMCs) as interbody grafts for the treatment of single-segment lumbar or lumbosacral spinal tuberculosis.Methods. From 2010 to 2018, 69 patients who underwent one-stage posterior debridement using grafts and internal fixation within a single lumbar or lumbosacral segment were included in this study. 12 cases using the SP combined with a TMC (SP+TMC, group A), 30 cases using a TMC only (group B), and 27 cases using allografts (group C) were included. Measurements including operative time, blood loss, hospital stay, visual analogue scale (VAS) score, Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), American Spinal Injury Association Impairment (ASIA) grade, final follow-up (FFU) duration and postoperative complications were recorded. Radiological measurements, including the number of segments fixated, the number of pedicle screws used, the Cobb angle, pelvic parameters, and the bony fusion time, were reviewed. All outcomes were analysed using SPSS 25.Results. We found that group A had fewer fixation segments (1.67±0.64 vs 2.81±0.94, pAC<0.01), fewer pedicle screws implanted (5.05±1.29 vs 6.85±1.37, pAC<0.01), a shorter operative time (166.43±44.11 min vs 205.93±51.73 min, pAC<0.01), reduced blood loss (543.81±230.81 ml vs 803.70±446.78 ml, pAC<0.01), and a strikingly lower hospital cost (14710.42±2354.55$ vs 19260.34±3310.75$, pAC<0.01) than group C.Compared to group B, group A had a lower economic cost (16680.23±3614.73$ vs 14710.42±2354.55$, pAB=0.03). There was no significant difference in bony fusion time among the three groups (8.90 ±2.11 months vs 8.60±2.39 months vs 9.59 ±2.04 months, p>0.01). No significant difference was observed with respect to pre- or postoperative ESR and CRP (p>0.01). There was no significant difference among the 3 groups with respect to the ODI, VAS score or ASIA grade during any period. No differences regarding the hospital stay, rate of complications, loss of PI-LL, correction or loss of Cobb angle were observed among the three groups (p>0.01).Conclusion. Our study demonstrates that compared to a TMC or allograft, the use of the SP combined with a TMC as a bone graft is an effective and reliable approach for the surgical management of one-level lumbar or lumbosacral spinal tuberculosis, leading to good restoration of spinal stability. Furthermore, this approach is an economical structural bone grafting method, especially for patients in developing countries or areas.

scholarly journals Effectiveness of Platelet Rich Plasma and Bone Graft in the Treatment of Intrabony Defects: A Clinico-radiographic Study

2018 ◽  
Vol 12 (1) ◽  
pp. 133-154 ◽  
Author(s):  
Mohammad Jalaluddin ◽  
Jayachandran Mahesh ◽  
Rethi Mahesh ◽  
Ipsita Jayanti ◽  
Mohamed Faizuddin ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Bone Graft ◽  
Alveolar Bone ◽  
Periodontal Regeneration ◽  
Periodontal Pocket ◽  
Controlled Study ◽  
Radiographic Evaluation ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background & Objectives: Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, loss of connective tissue attachment and alveolar bone around the affected tooth. Different modalities have been employed in the treatment and regeneration of periodontal defects which include the use of bone grafts, PRP and other growth factors.The purpose of this prospective, randomized controlled study was to compare the regenerative efficacy of PRP and bonegraft in intrabony periodontal defects. Methodology: This randomized control trial was carried out in the Department of Periodontics & Oral Implantology, Kalinga Institute of Dental Sciences and Hospital, KIIT University, Bhubaneswar. The study sample included 20 periodontal infrabony defects in 20 patients, 12 males and 8 females. The patients were aged between 25 -45 years(with mean age of 35 years). The 20 sites selected for the study were was randomly divided into 2 groups of 10 sites each. Group A: PRP alone, Group B: Bone Graft. Statistical Anaysis & Results: Statistical Analysis Was Done Using SPSS (Version 18.0): Statistical analysis was done usingpaired ‘t’ tests and ANOVA that revealed a significant reduction ingingival index, plaque index, probing pocket depth and gain in clinical attachment level at various time intervalswithin both the groups. Radiographic evaluation revealed statistically significant defect fill (p<0.001) at the end of 6months within both the groups. However, there was astatistically significant difference seen in group B radiographically, when compared to group A. Conclusion: Both the groups showed promising results in enhancing periodontal regeneration; however the resultswith bonegraftwere comparatively better, although not statistically significant when compared to PRP alone.

scholarly journals A comparative study of using temporalis fascia autograft and dehydrated temporal fascia homograft in tympanoplasty

2019 ◽  
Vol 5 (6) ◽  
pp. 1669
Author(s):  
Hemendra Bamaniya ◽  
Padam Chand Ajmera
Keyword(s):  
Graft Material ◽  
Age Group ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Medical College ◽  
Temporal Fascia ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> The objective of the present study was to compare the results of tympanoplasty operations performed using autograft temporalis fascia with those of dehydrated temporalis fascia homograft.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in the department of ENT of Pacific Medical College and Hospital, Udaipur in duration from February 2014 to January 2015. The study included 90 patients of chronic suppurative otitis media with dry, central perforation of tympanic membrane. The patients were divided into two groups with 45 members in each group. In group A, temporalis fascia autograft was used and in group B, dehydrated temporalis fascia homograft was used for tympanoplasty. Results were evaluated in terms of graft uptake rate and hearing improvement.  </p><p class="abstract"><strong>Results:</strong> There were 50 male and 40 female patients in the study. Most of the patients (43.33%) were of the age group 21-30 years, followed by age group 31-40 years (24.44%). Post-operatively, 95.55% patients in group A and 91.11% patients in group B showed successful graft uptake. Mean preoperative AB gap in group A patients was 31.46±6.78 dB which was reduced to 13.01±5.61 dB postoperatively. Similarly, in group B patients, AB gap was reduced from 29.81±5.99 to 12.92±6.01 dB postoperatively. No statistically significant difference was observed between groups while comparing pre and postoperative AB gap.</p><p class="abstract"><strong>Conclusions:</strong> The results of tympanoplasty done by using either homograft or autograft were the same so dehydrated temporalis fascia homograft can be used as an alternative graft material with the same success rate wherever possible with the advantage of reduction in duration of surgery.</p>

scholarly journals Investigation of The Optimal Surgical Approach to Brucella Lumbar Spondylitis Treatment: A Comparative Study

2020 ◽  
Author(s):  
Chenguang Jia ◽  
Jianguo Gao ◽  
Zhuo Li ◽  
Zhaoliang Dong ◽  
Liming Yao ◽  
...  
Keyword(s):  
Blood Loss ◽  
Bone Graft ◽  
Surgical Approach ◽  
Anterior Approach ◽  
Intraoperative Blood Loss ◽  
One Stage ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Group B

Abstract Background: The optimal surgical approach in treating lumbar brucellosis (LBS) has not been determined. This study aims to compare the surgical efficacy of anterior approach and combined posterior and anterior approach in treating LBS.Method: A retrospectively cohort study included LBS patients undergoing lumber surgery in the Department of Orthopedics, Department of Orthopedics, Hebei Province from June 2012 to June 2016. According surgical approach, patients were divided into two groups; patients with one-stage anterior approach were classified into group A, and the rest of patients with combined posterior and anterior approach were group B. The operative time, intraoperative blood loss and, hospitalization stay were recorded to compare the surgical risk of two groups. In terms of treatment efficacy, visual analogue scale (VAS), bone graft fusion, erythrocyte sedimentation rate (ESR) and Oswestry disability index (ODI) were assessed and compared before and after surgery.Results: Eight-nine patients with LBS were included into the study. Fifty cases were males, and 39 patients were female. The mean age of this cohort was 61.9 ± 12 years, ranging from 23 to 78 years. Forty-nine patients were divided into group A, undergoing anterior debridement and bone graft fusion. Forty patients underwent posterior fixation combined with anterior approach (group B). The operation time of group A was 30 minutes shorter than that of group B. Group A had less intraoperative blood loss (800 vs. 900 ml; P <0.001). Hospital stay was four days shorter in group A. At the last follow-up, all patients were in good condition with ASIA Level E and ESR returned to normal. The bone fusion rate of Bridwell bone was 89.29% (45/49) and 80.00% (38/40) of group A and group B, respectively. In terms of surgical efficacy, there was no significant difference in VAS score between the two groups before and after operation (P > 0.05). Conclusions: One-stage anterior approach and combine posterior-anterior approach had no significant difference in terms of clinical efficacy. Individualized surgical treatment should be suggested in patients with complicated LBS and ineffective therapeutic treatment. Trial registration: This study has been retrospectively registered in local ethical Institution Review Board(No:[2020]068).

scholarly journals Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Changsheng Yang ◽  
Wentao Zhuo ◽  
Qingchu Li ◽  
Caiqiang Huang ◽  
Huibo Yan ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Donor Site ◽  
Fusion Rate ◽  
Iliac Bone ◽  
Anterior Cervical Discectomy ◽  
Allogeneic Bone ◽  
Cervical Discectomy ◽  
Cage Subsidence ◽  
Group A ◽  
Group B

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.

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