scholarly journals Repair of Iliac Crest Defects with a Hydroxyapatite/Collagen Composite

2020 ◽  
Vol 14 (6) ◽  
pp. 808-813
Author(s):  
Koichi Murata ◽  
Shunsuke Fujibayashi ◽  
Bungo Otsuki ◽  
Takayoshi Shimizu ◽  
Shuichi Matsuda
Keyword(s):  
Cancellous Bone ◽  
Interbody Fusion ◽  
Iliac Crest ◽  
Bone Defects ◽  
Iliac Crest Bone Graft ◽  
Dependent Manner ◽  
Long Time ◽  
Lateral Interbody ◽  
Bone Void ◽  
Immunologic Properties

Study Design: Retrospective study.Purpose: This study aimed to assess the effect of refilling with hydroxyapatite/collagen (HAp/Col) composite on an iliac crest defect after spinal fusion.Overview of Literature: The use of iliac crest bone graft has been the gold standard in spinal fusion for a long time because of its biological and non-immunologic properties. Few reports have addressed how bone defects recover after iliac crest bone harvest following spinal fusion.Methods: Cancellous bone was collected from the anterior iliac crest during lateral interbody fusion (LIF), and the bone void of the ilium was refilled with a porous HAp/Col composite. We assessed bone recovery using computed tomography (CT). From the 74 patients who underwent LIF between January 2015 and December 2016, we included 49 patients whose iliac crest could be evaluated using CT at 3 months and 1 year after the surgery.Results: Bone defects decreased in a time-dependent manner after the surgery. Cortical closure was observed in 28.5% of the cases 3 months after the surgery; at 1 year postoperatively, 95.9% of the patients had cortical closure. Complete repair of the cancellous bone was achieved in 57.1% of the patients at 3 months after the surgery and in 95.9% at 1 year after the surgery. There were no significant hematomas, infections, iliac crest fractures, or soft tissue herniation.Conclusions: Radiographic recovery of cortical and cancellous bone defects was achieved with high probability via refilling with HAp/Col composite over the 1-year period.

Optimizing Safety of Iliac Bone Harvest Using an Acumed Drill: A Simulated Radiographic Study of 100 Patients

2017 ◽  
Vol 54 (6) ◽  
pp. 674-679 ◽  
Author(s):  
John T. Stranix ◽  
Daniel Cuzzone ◽  
Catherine Ly ◽  
Nicole Topilow ◽  
Christopher M. Runyan ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cortical Thickness ◽  
Cancellous Bone ◽  
Reference Point ◽  
Iliac Crest ◽  
Bowel Perforation ◽  
Iliac Bone ◽  
Iliac Crest Bone Graft ◽  
Visceral Injury ◽  
Graft Harvest

Objective To determine the potential risk of visceral injury during Acumed drill iliac crest cancellous bone graft harvest. Design Radiographic iliac crest anatomic analysis with simulated drill course to measure cancellous bone available for harvest and proximity of vulnerable pelvic structures. Setting Single institution, tertiary care university hospital. Patients and Participants One hundred pelvic computed tomography scans performed on children 8 to 12 years old without traumatic or neoplastic pathology. Interventions Radiographic simulation of Acumed drill course within iliac bone. Main Outcome Measures (1) Potential for pelvic visceral injury. (2) Volume of cancellous bone safely available for harvest. Results Superior and medial cortical thickness at the reference point remained stable across age groups; however, lateral cortical thickness increased with age (3.13 to 3.74 mm, P < .001). Cancellous bone width increased with age at all depths measured ( P < .001). Through radiographic simulation, the drill could reach the bowel in 4% of cases and only through gross deviation (>30°) from the plane of the ilium. There were no cases of simulated bowel perforation within 3 cm of the reference point. The maximum cancellous volume safely harvested increased with age: 24 cc in 8-year-olds to 36 cc in 12-year-olds ( P < .001). Conclusions Acumed assisted iliac crest bone graft harvest is a safe technique in which substantial amount of cancellous bone can be obtained. The low risk of bowel perforation can be further minimized by limiting the depth of drill bit penetration to less than 3 cm.

Influence of cage design on interbody fusion in a sheep cervical spine model

2002 ◽  
Vol 96 (3) ◽  
pp. 321-332 ◽  
Author(s):  
Frank Kandziora ◽  
Georg Schollmeier ◽  
Matti Scholz ◽  
Jan Schaefer ◽  
Alexandra Scholz ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Mineral ◽  
Interbody Fusion ◽  
Iliac Crest ◽  
Bone Matrix ◽  
Iliac Crest Bone Graft ◽  
Disc Space ◽  
Content Type ◽  
Flexion Extension ◽  
Fine Print

Object. The purpose of this study was to compare the characteristics of interbody fusion achieved using an autologous tricortical iliac crest bone graft with those of a cylinder- and a box-design cage in a sheep cervical spine model. This study was designed to determine whether there are differences between three interbody fusion procedures in: 1) ability to preserve postoperative distraction; 2) biomechanical stability; and 3) histological characteristics of intervertebral bone matrix formation. Methods. Twenty-four sheep underwent C3–4 discectomy and fusion in which the following were used: Group 1, autologous tricortical iliac crest bone graft (eight sheep); Group 2, titanium cylinder-design cage filled with autologous iliac crest bone graft (eight sheep); and Group 3, titanium box-design cage filled with autologous iliac crest graft (eight sheep). Radiography was performed pre- and postoperatively and after 1, 2, 4, 8, and 12 weeks. At the same time points, disc space height, intervertebral angle, and lordosis angle were measured. After 12 weeks, the sheep were killed, and fusion sites were evaluated by obtaining functional radiographs in flexion and extension. Quantitative computerized tomography scans were acquired to assess bone mineral density, bone mineral content, and bone callus volume. Biomechanical testing was performed in flexion, extension, axial rotation, and lateral bending. Stiffness, range of motion, neutral zone, and elastic zone were determined. Histomorphological and histomorphometric analyses were performed, and polychrome sequential labeling was used to determine the time frame of new bone formation. Over a 12-week period significantly higher values for disc space height and intervertebral angle were shown in cage-treated sheep than in those that received bone graft. Functional radiographic assessment revealed significantly lower residual flexion—extension movement in sheep with the cylinder cage-fixed spines than in those that received bone graft group. The cylinder—design cages showed significantly higher values for bone mineral content, bone callus content, and stiffness in axial rotation and lateral bending than the other cages or grafts. Histomorphometric evaluation and polychrome sequential labeling showed a more progressed bone matrix formation in the cylindrical cage group than in both other groups. Conclusions. Compared with the tricortical bone graft, both cages showed significantly better distractive properties. The cylindrical cage demonstrated a significantly higher biomechanical stiffness and an accelerated interbody fusion compared with the box-design cage and the tricortical bone graft. The differences in bone matrix formation within both cages were the result of the significantly lower stress shielding on the bone graft by the cylinder-design cage.

Iliac Crest Bone Graft for Minimally Invasive Transforaminal Lumbar Interbody Fusion

Spine ◽  
2018 ◽  
pp. 1 ◽  
Author(s):  
Brittany E. Haws ◽  
Benjamin Khechen ◽  
Ankur S. Narain ◽  
Fady Y. Hijji ◽  
Kaitlyn L. Cardinal ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Bone Graft ◽  
Interbody Fusion ◽  
Iliac Crest ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Iliac Crest Bone Graft ◽  
Lumbar Interbody Fusion

scholarly journals Miniopen Oblique Lateral L5-S1 Interbody Fusion: A Report of 2 Cases

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Keijiro Kanno ◽  
Seiji Ohtori ◽  
Sumihisa Orita ◽  
Kazuyo Yamauchi ◽  
Yawara Eguchi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Iliac Crest ◽  
Spinal Nerve ◽  
Leg Pain ◽  
Foraminal Stenosis ◽  
Lateral Interbody Fusion ◽  
Major Vessel ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Extreme lateral interbody fusion (XLIF) has been widely used for minimally invasive anterior lumbar interbody fusion (ALIF), but an approach to L5-S1 is difficult because of the iliac crest. In the current study, we present 2 cases using minimally invasive oblique lateral interbody fusion (OLIF) of L5-S1. The patients showed foraminal stenosis between L5 and S1 and severe low back and leg pain. The patients were placed in a lateral decubitus position and underwent OLIF surgery (using a cage and bone graft from the iliac crest) without posterior decompression. Posterior screws were used in the patients. Pain scores significantly improved after surgery. There was no spinal nerve, major vessel, peritoneal, or urinary injury. OLIF surgery was minimally invasive and produced good surgical results without complications.

scholarly journals Regenerative Strategies in Cleft Palate: An Umbrella Review

2021 ◽  
Vol 8 (6) ◽  
pp. 76
Author(s):  
Inês Francisco ◽  
Anabela Baptista Paula ◽  
Bárbara Oliveiros ◽  
Maria Helena Fernandes ◽  
Eunice Carrilho ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Bone Graft ◽  
Gold Standard ◽  
Iliac Crest ◽  
Alveolar Bone ◽  
Standard Technique ◽  
Bone Defects ◽  
Cochrane Library ◽  
Iliac Crest Bone Graft ◽  
Umbrella Review

(1) Background: Alveolar bone defects or decreased alveolar bone height and width may have different causes, such as cleft palate. Regenerative procedures in oro-dental defects are challenging due to anatomical factors and the distinct cell populations involved. The iliac crest bone graft remains the gold-standard for cleft palate closure. However, tissue regeneration approaches have been employed and their outcome reviewed, but no conclusions have been made about which one is the gold-standard. (2) Methods: this umbrella review aims to critically appraise the effectiveness of the current approaches in bone defects regeneration in non-syndromic patients with cleft palate. A search was performed in PubMed, Cochrane Library, Scopus, Web of Science and EMBASE databases. (3) Results: Systematic reviews of randomized and non-randomized controlled trials with or without meta-analysis were included. Nine articles were included in the qualitative analysis and five in the quantitative one. The included studies quality was evaluated with AMSTAR2. (4) Conclusions: The use of new regenerative strategies, such as bone morphogenic protein 2, appears to provide similar results regarding bone volume, filling, and height to the standard technique with the iliac crest bone graft.

Peptide Enhanced Bone Graft Substitute Presents Improved Short-Term Increase in Bone Volume and Construct Stiffness Compared to Iliac Crest Autologous Bone in an Ovine Lumbar Interbody Fusion Model

2021 ◽  
pp. 219256822097983
Author(s):  
Arjan C. Y. Loenen ◽  
Jerome Connor ◽  
Scott Johnson ◽  
Katherine Davis ◽  
Nolan Hannigan ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Remodeling ◽  
Interbody Fusion ◽  
Iliac Crest ◽  
Bone Graft Substitute ◽  
Iliac Crest Bone Graft ◽  
Graft Material ◽  
Lumbar Interbody Fusion ◽  
Ovine Model ◽  
Systemic Health

Study design: Preclinical ovine model. Objective: To assess the in vivo efficacy and safety of the P-15 L bone graft substitute and compare its performance to autologous iliac crest bone graft (ICBG) for lumbar interbody fusion indications. Methods: Thirty skeletally mature sheep underwent lumbar interbody fusion surgery. Half of the sheep received autologous ICBG and the other half the peptide enhanced bone graft substitute (P-15 L). Following termination at 1, 3, and 6 months after surgery, the operated segments were analyzed using micro computed tomography (µCT), histology, and destructive mechanical testing. Additional systemic health monitoring was performed for the P-15 L group. Results: One month after surgery, there was only minor evidence of bone remodeling and residual graft material could be clearly observed within the cage. There was active bone remodeling between 1 and 3 months after surgery. At 3 months after surgery significantly denser and stiffer bone was found in the P-15 L group, whereas at 6 months, P-15 L and ICBG gave similar fusion results. The P-15 L bone graft substitute did not have any adverse effects on systemic health. Conclusions: The drug device combination P-15 L was demonstrated to be effective and save for lumbar interbody fusion as evidenced by this ovine model. Compared to autologous ICBG, P-15 L seems to expedite bone formation and remodeling but in the longer-term fusion results were similar.

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