Posterior lumbar interbody fusion using dense hydroxyapatite blocks and autogenous iliac bone: Clinical and radiographic examinations

Takashi Asazuma, Kazunori Masuoka, Takao Motosuneya, Takashi Tsuji, Hiroki Yasuoka, Kyosuke Fujikawa

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Posterior lumbar interbody fusion (PLIF) is a standard surgical technique for the lumbar degenerative diseases. However, some problems such as collapse or retropulsion of the grafted bone and pseudoarthrosis have been reported when autogenous or cadaveric bone is used. Two iliac bone blocks with one-side cortex and one dense hydroxyapatite (HA) block were grafted together into the interbody space as in a sandwich. Cancellous bone chips locally harvested were also grafted onto the anterior and lateral aspect of the HA block. Twenty-six patients (12 males, 14 females) who could be followed minimally for 2 years were examined. The surgical outcome of each patient was evaluated by the Japanese Orthopaedic Association Assessment of Treatment of Low Back Pain (JOA score) and the recovery rate. Radiographic evaluation was based on the extent of bony union, the presence of a clear zone in the upper or lower margin of the HA block, cracking of the HA block, sinking of the HA block, and changes in lumbar-sagittal alignment pre- and postoperatively. The overall recovery rate ranged from 42.9% to 100% (mean 88.3%). Bony union was confirmed in 25 patients (96.2%). Clear zone was observed in 9 of 68 contact surfaces (13.2%). Sinking was observed in 8 of 34 segments (23.5%), and cracking of HA block was observed in 6 segments (17.6%). A mean loss of lordosis was found to be 2.4°. The dense HA block is a useful substitute for autogenous bone graft for PLIF.

Original languageEnglish
JournalJournal of Spinal Disorders and Techniques
Volume18
Issue numberSUPPL. 1
DOIs
Publication statusPublished - 01-02-2005
Externally publishedYes

Fingerprint

Durapatite
Bone and Bones
Bone Substitutes
Lordosis
Pseudarthrosis
Low Back Pain
Transplants

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Asazuma, Takashi ; Masuoka, Kazunori ; Motosuneya, Takao ; Tsuji, Takashi ; Yasuoka, Hiroki ; Fujikawa, Kyosuke. / Posterior lumbar interbody fusion using dense hydroxyapatite blocks and autogenous iliac bone : Clinical and radiographic examinations. In: Journal of Spinal Disorders and Techniques. 2005 ; Vol. 18, No. SUPPL. 1.
@article{51bea0ffd4ab4090a2113e80545435f6,
title = "Posterior lumbar interbody fusion using dense hydroxyapatite blocks and autogenous iliac bone: Clinical and radiographic examinations",
abstract = "Posterior lumbar interbody fusion (PLIF) is a standard surgical technique for the lumbar degenerative diseases. However, some problems such as collapse or retropulsion of the grafted bone and pseudoarthrosis have been reported when autogenous or cadaveric bone is used. Two iliac bone blocks with one-side cortex and one dense hydroxyapatite (HA) block were grafted together into the interbody space as in a sandwich. Cancellous bone chips locally harvested were also grafted onto the anterior and lateral aspect of the HA block. Twenty-six patients (12 males, 14 females) who could be followed minimally for 2 years were examined. The surgical outcome of each patient was evaluated by the Japanese Orthopaedic Association Assessment of Treatment of Low Back Pain (JOA score) and the recovery rate. Radiographic evaluation was based on the extent of bony union, the presence of a clear zone in the upper or lower margin of the HA block, cracking of the HA block, sinking of the HA block, and changes in lumbar-sagittal alignment pre- and postoperatively. The overall recovery rate ranged from 42.9{\%} to 100{\%} (mean 88.3{\%}). Bony union was confirmed in 25 patients (96.2{\%}). Clear zone was observed in 9 of 68 contact surfaces (13.2{\%}). Sinking was observed in 8 of 34 segments (23.5{\%}), and cracking of HA block was observed in 6 segments (17.6{\%}). A mean loss of lordosis was found to be 2.4°. The dense HA block is a useful substitute for autogenous bone graft for PLIF.",
author = "Takashi Asazuma and Kazunori Masuoka and Takao Motosuneya and Takashi Tsuji and Hiroki Yasuoka and Kyosuke Fujikawa",
year = "2005",
month = "2",
day = "1",
doi = "10.1097/01.bsd.0000112043.70321.1a",
language = "English",
volume = "18",
journal = "Journal of Spinal Disorders",
issn = "1536-0652",
publisher = "Lippincott Williams and Wilkins",
number = "SUPPL. 1",

}

Posterior lumbar interbody fusion using dense hydroxyapatite blocks and autogenous iliac bone : Clinical and radiographic examinations. / Asazuma, Takashi; Masuoka, Kazunori; Motosuneya, Takao; Tsuji, Takashi; Yasuoka, Hiroki; Fujikawa, Kyosuke.

In: Journal of Spinal Disorders and Techniques, Vol. 18, No. SUPPL. 1, 01.02.2005.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Posterior lumbar interbody fusion using dense hydroxyapatite blocks and autogenous iliac bone

T2 - Clinical and radiographic examinations

AU - Asazuma, Takashi

AU - Masuoka, Kazunori

AU - Motosuneya, Takao

AU - Tsuji, Takashi

AU - Yasuoka, Hiroki

AU - Fujikawa, Kyosuke

PY - 2005/2/1

Y1 - 2005/2/1

N2 - Posterior lumbar interbody fusion (PLIF) is a standard surgical technique for the lumbar degenerative diseases. However, some problems such as collapse or retropulsion of the grafted bone and pseudoarthrosis have been reported when autogenous or cadaveric bone is used. Two iliac bone blocks with one-side cortex and one dense hydroxyapatite (HA) block were grafted together into the interbody space as in a sandwich. Cancellous bone chips locally harvested were also grafted onto the anterior and lateral aspect of the HA block. Twenty-six patients (12 males, 14 females) who could be followed minimally for 2 years were examined. The surgical outcome of each patient was evaluated by the Japanese Orthopaedic Association Assessment of Treatment of Low Back Pain (JOA score) and the recovery rate. Radiographic evaluation was based on the extent of bony union, the presence of a clear zone in the upper or lower margin of the HA block, cracking of the HA block, sinking of the HA block, and changes in lumbar-sagittal alignment pre- and postoperatively. The overall recovery rate ranged from 42.9% to 100% (mean 88.3%). Bony union was confirmed in 25 patients (96.2%). Clear zone was observed in 9 of 68 contact surfaces (13.2%). Sinking was observed in 8 of 34 segments (23.5%), and cracking of HA block was observed in 6 segments (17.6%). A mean loss of lordosis was found to be 2.4°. The dense HA block is a useful substitute for autogenous bone graft for PLIF.

AB - Posterior lumbar interbody fusion (PLIF) is a standard surgical technique for the lumbar degenerative diseases. However, some problems such as collapse or retropulsion of the grafted bone and pseudoarthrosis have been reported when autogenous or cadaveric bone is used. Two iliac bone blocks with one-side cortex and one dense hydroxyapatite (HA) block were grafted together into the interbody space as in a sandwich. Cancellous bone chips locally harvested were also grafted onto the anterior and lateral aspect of the HA block. Twenty-six patients (12 males, 14 females) who could be followed minimally for 2 years were examined. The surgical outcome of each patient was evaluated by the Japanese Orthopaedic Association Assessment of Treatment of Low Back Pain (JOA score) and the recovery rate. Radiographic evaluation was based on the extent of bony union, the presence of a clear zone in the upper or lower margin of the HA block, cracking of the HA block, sinking of the HA block, and changes in lumbar-sagittal alignment pre- and postoperatively. The overall recovery rate ranged from 42.9% to 100% (mean 88.3%). Bony union was confirmed in 25 patients (96.2%). Clear zone was observed in 9 of 68 contact surfaces (13.2%). Sinking was observed in 8 of 34 segments (23.5%), and cracking of HA block was observed in 6 segments (17.6%). A mean loss of lordosis was found to be 2.4°. The dense HA block is a useful substitute for autogenous bone graft for PLIF.

UR - http://www.scopus.com/inward/record.url?scp=21344459767&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=21344459767&partnerID=8YFLogxK

U2 - 10.1097/01.bsd.0000112043.70321.1a

DO - 10.1097/01.bsd.0000112043.70321.1a

M3 - Article

C2 - 15699804

AN - SCOPUS:21344459767

VL - 18

JO - Journal of Spinal Disorders

JF - Journal of Spinal Disorders

SN - 1536-0652

IS - SUPPL. 1

ER -