scholarly journals Bone Graft in the Treatment of the Non-Consolidation of the Scaphoid with Necrosis of the Proximal Pole – A Systematic Review

2020 ◽  
Author(s):  
Antônio Lourenço Severo ◽  
Osvandre Lech ◽  
Paulo Cesar Faiad Piluski ◽  
Marcelo Barreto Lemos ◽  
Carlos Castillo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Graft ◽  
Proximal Pole

scholarly journals Outcomes of Local Bone Graft and Fixation of Proximal Pole Scaphoid Nascent Nonunions and Nonunions

2020 ◽  
Vol 09 (03) ◽  
pp. 203-208
Author(s):  
Kristin E. Shoji ◽  
F. Joseph Simeone ◽  
Sezai Ozkan ◽  
Chaitanya S. Mudgal
Keyword(s):  
Bone Graft ◽  
Common Mechanism ◽  
Study Cohort ◽  
Proximal Pole ◽  
Scaphoid Fractures ◽  
Local Bone ◽  
Case Series Study ◽  
Increased Risk ◽  
Surgical Fixation ◽  
The Mean

Abstract Background Fractures of the proximal pole of the scaphoid have an increased risk of nonunion due to its tenuous blood supply. The optimal treatment of proximal pole scaphoid nonunions remains controversial. Objectives To review a single surgeon's experience with proximal pole scaphoid nascent nonunions (delayed unions) and nonunions that underwent surgical fixation with a cannulated headless compression screw and local autologous bone graft from the distal radius. Patients and Methods After obtaining Institutional Review Board approval, the electronic medical record of one tertiary care center was queried for patients with the diagnosis of “proximal pole scaphoid fractures” who underwent surgical fixation by a single surgeon over an 11-year period (2006–2017). Fifteen patients met initial query criteria; upon review of records, four patients were excluded due to the acute nature of the fracture, and one was excluded as surgical fixation included a vascularized bone graft. Results The final study cohort consisted of 10 patients with a total of 10 proximal pole scaphoid nonunions. Almost all of the patients in this study were male (9/10 [90%]), and sporting activities were the most common mechanism of injury (8/10 [80%]). Volumetric measurements of the scaphoid fractures on computed tomography (CT) revealed that the mean total volume of the scaphoid was 2.4 ± 0.48 cm3 and the mean volume of the proximal pole fragment was 0.38 ± 0.15 cm3. Postoperative CT scans were performed at a mean of 12.4 weeks (range: 8–16 weeks), with seven (7/10 [70%]) showing signs of complete union and three (3/10 [30%]) demonstrating partial union. None of the patients required additional procedures and there were no complications. Conclusions Our results suggest that proximal pole scaphoid fractures with delayed union and nonunion treated with surgical fixation and autologous local bone graft heal without the need for more complex vascularized procedures. The volume of the proximal pole fragment did not correlate with increased risk of ongoing nonunion after the index procedure. Level of Evidence This is a Level IV, case series study.

scholarly journals Synthetic bone graft versus autograft or allograft for spinal fusion: a systematic review

2016 ◽  
Vol 25 (4) ◽  
pp. 509-516 ◽  
Author(s):  
Zorica Buser ◽  
Darrel S. Brodke ◽  
Jim A. Youssef ◽  
Hans-Joerg Meisel ◽  
Sue Lynn Myhre ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Bone Graft ◽  
Spinal Fusion ◽  
Comparative Studies ◽  
Functional Outcomes ◽  
Retrospective Studies ◽  
Synthetic Bone ◽  
Synthetic Bone Graft ◽  
Bone Graft Substitutes

The purpose of this review was to compare the efficacy and safety of synthetic bone graft substitutes versus autograft or allograft for the treatment of lumbar and cervical spinal degenerative diseases. Multiple major medical reference databases were searched for studies that evaluated spinal fusion using synthetic bone graft substitutes (either alone or with an autograft or allograft) compared with autograft and allograft. Randomized controlled trials (RCT) and cohort studies with more than 10 patients were included. Radiographic fusion, patient-reported outcomes, and functional outcomes were the primary outcomes of interest. The search yielded 214 citations with 27 studies that met the inclusion criteria. For the patients with lumbar spinal degenerative disease, data from 19 comparative studies were included: 3 RCTs, 12 prospective, and 4 retrospective studies. Hydroxyapatite (HA), HA+collagen, β-tricalcium phosphate (β-TCP), calcium sulfate, or polymethylmethacrylate (PMMA) were used. Overall, there were no differences between the treatment groups in terms of fusion, functional outcomes, or complications, except in 1 study that found higher rates of HA graft absorption. For the patients with cervical degenerative conditions, data from 8 comparative studies were included: 4 RCTs and 4 cohort studies (1 prospective and 3 retrospective studies). Synthetic grafts included HA, β-TCP/HA, PMMA, and biocompatible osteoconductive polymer (BOP). The PMMA and BOP grafts led to lower fusion rates, and PMMA, HA, and BOP had greater risks of graft fragmentation, settling, and instrumentation problems compared with iliac crest bone graft. The overall quality of evidence evaluating the potential use and superiority of the synthetic biological materials for lumbar and cervical fusion in this systematic review was low or insufficient, largely due to the high potential for bias and small sample sizes. Thus, definitive conclusions or recommendations regarding the use of these synthetic materials should be made cautiously and within the context of the limitations of the evidence.

scholarly journals Spinal Biologics in Minimally Invasive Lumbar Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-15 ◽  
Author(s):  
Kevin Y. Chang ◽  
Wellington K. Hsu
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Bone Graft ◽  
Lumbar Surgery ◽  
Spinal Arthrodesis ◽  
Optimal Fusion ◽  
Bone Graft Substitutes ◽  
Minimally Invasive Spine

As the use of minimally invasive spine (MIS) fusion approaches continues to grow, increased scrutiny is being placed on its outcomes and efficacies against traditional open fusion surgeries. While there are many factors that contribute to the success of achieving spinal arthrodesis, selecting the optimal fusion biologic remains a top priority. With an ever-expanding market of bone graft substitutes, it is important to evaluate each of their use as it pertains to MIS techniques. This review will summarize the important characteristics and properties of various spinal biologics used in minimally invasive lumbar surgeries and compare their fusion rates via a systematic review of published literature.

scholarly journals The Use of Tooth Derived Bone Graft Materials in Sinus Augmentation Procedures: a Systematic Review

2019 ◽  
Vol 10 (2) ◽  
Author(s):  
Eliyahu Shavit ◽  
Ilana Shavit ◽  
Daniel Pinchasov ◽  
David Shavit ◽  
Ginnady Pinchasov ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Graft ◽  
Sinus Augmentation

scholarly journals Investigating the efficacy of allograft cellular bone matrix for spinal fusion: a systematic review of the literature

2021 ◽  
Vol 50 (6) ◽  
pp. E11
Author(s):  
Ryan R. Diaz ◽  
Amey R. Savardekar ◽  
Jared R. Brougham ◽  
Danielle Terrell ◽  
Anthony Sin
Keyword(s):  
Systematic Review ◽  
Bone Graft ◽  
Spinal Fusion ◽  
Bone Matrix ◽  
Small Sample ◽  
Human Studies ◽  
Limiting Factors ◽  
Cochrane Library ◽  
Iliac Crest Bone Graft ◽  
Cellular Bone

OBJECTIVE The use of allograft cellular bone matrices (ACBMs) in spinal fusion has expanded rapidly over the last decade. Despite little objective data on its effectiveness, ACBM use has replaced the use of traditional autograft techniques, namely iliac crest bone graft (ICBG), in many centers. METHODS In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was conducted of the PubMed, Cochrane Library, Scopus, and Web of Science databases of English-language articles over the time period from January 2001 to December 2020 to objectively assess the effectiveness of ACBMs, with an emphasis on the level of industry involvement in the current body of literature. RESULTS Limited animal studies (n = 5) demonstrate the efficacy of ACBMs in spinal fusion, with either equivalent or increased rates of fusion compared to autograft. Clinical human studies utilizing ACBMs as bone graft expanders or bone graft substitutes (n = 5 for the cervical spine and n = 8 for the lumbar spine) demonstrate the safety of ACBMs in spinal fusion, but fail to provide conclusive level I, II, or III evidence for its efficacy. Additionally, human studies are plagued with several limiting factors, such as small sample size, lack of prospective design, lack of randomization, absence of standardized assessment of fusion, and presence of industry support/relevant conflict of interest. CONCLUSIONS There exist very few objective, unbiased human clinical studies demonstrating ACBM effectiveness or superiority in spinal fusion. Impartial, well-designed prospective studies are needed to offer evidence-based best practices to patients in this domain.

scholarly journals Bone Graft as an Adjunctive Treatment for Delayed Union and Non-Union of Fractures in Dogs: Systematic Review.

2020 ◽  
pp. 1-7
Keyword(s):  
Systematic Review ◽  
Bone Graft ◽  
Companion Animals ◽  
Delayed Union ◽  
Adjunctive Treatment ◽  
Financial Investment ◽  
Non Union ◽  
Scientific Databases ◽  
Orthopedic Patient ◽  
Substitute Materials

Abstract The cases of non-union or delayed union are the main diagnoses related to complications of orthopedic fractures within the veterinary surgery of companion animals, mainly dogs. Bone graft transplantation is a growing competence as an adjuvant treatment in these cases. The study reveals its use through the evaluation of the data obtained in an advanced research on the topic referring to the main scientific databases, resulting in a systematic review, in addition to proving its means of extraction and conservation. Although there is the possibility of performing autograft and xenograft, among other substitute materials, a choice on the part of the veterinarian must make a tiny assessment of each case. However, this therapeutic approach requires greater professional, structural and, consequently, financial investment by veterinarians and hospital doctors. As well as, the realization of scientific works with the objective of contributing to the evolution of this method of associated treatment and bringing more and more benefits to the orthopedic patient.

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