A composite bone graft substitute for anterior cervical fusion: assessment of osseointegration by quantitative computed tomography.


STUDY DESIGN:An ongoing prospective nonrandomized trial was conducted with 146 patients who underwent anterior cervical fusion with a bone graft substitute. The results for 78 patients followed up a minimum of 2 years are reported by an independent observer. OBJECTIVE:To investigate the clinical efficacy and osseointegration of the implant. SUMMARY OF BACKGROUND DATA:Most of the cervical cages provide an immediate load-bearing capacity, but not necessarily a solid fusion. The bony ingrowth can hardly be evaluated by flexion-extension plain radiographs, especially if a part of the implant is made of titanium. METHODS:The composite bone graft substitute consists of a rectangular fenestrated titanium cage filled with a highly porous hydroxyapatite cylinder soaked with bone marrow aspirated from a vertebra. Altogether, 102 implants were inserted for anterior cervical fusion. The bone ingrowth was measured in 50 patients by quantitative computed tomography of the implant and the adjacent vertebrae after 1 week, then 6 and 12 months after surgery. The investigation was repeated in 24 randomly selected patients 24 months after surgery. RESULTS:The surgery benefited 42 of 48 patients with myelopathy, 27 of 28 patients with radiculopathy, and both patients with anterior horn cell syndrome. No graft substitute-related complications were observed, and no revision surgery was performed. Six months after surgery, quantitative computed tomography showed up to a 14% increase in the hydroxyapatite mass in the core of the implant, which was statistically significant (P < 0.001). At 1 year, the newly formed hydroxyapatite mass increased to 23%, and in 2 years reached 24%. CONCLUSIONS:The composite implant is effective as a bone graft substitute, providing immediate load-bearing capacity, an osteoconductive scaffold, and osteoinductive potency. After surgery, the increase in hydroxyapatite radiodensity was apparent in plain computed tomography scans and confirmed to be significant by quantitative computed tomography.


Spine (Phila Pa 1976)




Papavero L,Zwönitzer R,Burkard I,Klose K,Herrmann HD





Has Abstract


2002-05-15 00:00:00














  • Aggrecanases and aggrecanase-generated fragments in the human intervertebral disc at early and advanced stages of disc degeneration.

    abstract:STUDY DESIGN:A comparative study of aggrecanases and aggrecan fragmentation profile in the human intervertebral disc at early and advanced stages of disc degeneration. OBJECTIVE:To determine differences in the content of the aggrecanases and the profile of aggrecan fragmentation in early and advanced stages of disc de...


    pub_type: 杂志文章


    authors: Patel KP,Sandy JD,Akeda K,Miyamoto K,Chujo T,An HS,Masuda K

    更新日期:2007-11-01 00:00:00

  • Far lateral disc herniations treated by microscopic fragment excision. Techniques and results.

    abstract:STUDY DESIGN:This was a retrospective review of a consecutive series of patients who underwent excision of far lateral disc herniations by a paraspinal, muscle-splitting incision that spares the facet. OBJECTIVE:The authors describe the surgical technique in detail and review the results of surgical treatment. SUMMAR...


    pub_type: 杂志文章


    authors: Darden BV 2nd,Wade JF,Alexander R,Wood KE,Rhyne AL 3rd,Hicks JR

    更新日期:1995-07-01 00:00:00

  • A prospective follow-up study of low back pain in the community.

    abstract:STUDY DESIGN:Opportunistic prospective follow-up study. OBJECTIVE:To describe the natural history of low back pain in the community and to model the factors predictive of recovered versus persistent low back pain. SUMMARY OF BACKGROUND DATA:A two-phase questionnaire was mailed to adults in the Bradford Metropolitan H...


    pub_type: 杂志文章


    authors: Waxman R,Tennant A,Helliwell P

    更新日期:2000-08-15 00:00:00

  • The Effect of Local Intraoperative Steroid Administration on the Rate of Postoperative Dysphagia Following ACDF: A Study of 245,754 Patients.

    abstract:STUDY DESIGN:A retrospective database analysis. OBJECTIVE:The aim of this study is to compare rates of postoperative dysphagia, length of stay, infection, and wound complications following short and long anterior cervical discectomy and fusion (ACDF) in patients who received local intraoperative steroids and those who...


    pub_type: 杂志文章


    authors: Cancienne JM,Werner BC,Loeb AE,Yang SS,Hassanzadeh H,Singla A,Shen FH,Shimer AL

    更新日期:2016-07-01 00:00:00

  • Pain response to sagittal end-range spinal motion. A prospective, randomized, multicentered trial.

    abstract::This article reports a prospective, randomized, multicentered study documenting changes in the intensity and location of low-back and referred pain to repeated end-range lumbar flexion and extension movements performed first while standing and then while recumbent during a single clinical patient evaluation. Significa...


    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Donelson R,Grant W,Kamps C,Medcalf R

    更新日期:1991-06-01 00:00:00

  • Magnetic resonance imaging in cadaver dogs with metallic vertebral implants at 3 Tesla: evaluation of the WARP-turbo spin echo sequence.

    abstract:STUDY DESIGN:Laboratory investigation, ex vivo. OBJECTIVE:Postoperative complications are common after spinal implantation procedures, and magnetic resonance imaging (MRI) would be the ideal modality to image these patients. Unfortunately, the implants cause artifacts that can render MRI nondiagnostic. The WARP-turbo ...


    pub_type: 杂志文章


    authors: Griffin JF 4th,Archambault NS,Mankin JM,Wall CR,Thompson JA,Padua A Jr,Purdy D,Kerwin SC

    更新日期:2013-11-15 00:00:00

  • Temporary Iliac Fixation to Salvage an Acute L4 Chance Fracture: Following Pedicle Screw Fixation for Adolescent Idiopathic Scoliosis.

    abstract:STUDY DESIGN:A case report. OBJECTIVE:The aim of this study was to describe a technique of temporary distal fixation to the ilium to salvage an acute L4 fracture following a T3-L4 kyphoscoliosis correction. SUMMARY OF BACKGROUND DATA:Pedicle fracture is a possible complication in pedicle screw fixation for scoliosis,...


    pub_type: 杂志文章


    authors: Kato S,Lewis SJ

    更新日期:2017-03-01 00:00:00

  • The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex.

    abstract:STUDY DESIGN:The classification system was derived through a literature review and expert opinion of experienced spine surgeons. In addition, a multicenter reliability and validity study of the system was conducted on a collection of trauma cases. OBJECTIVES:To define a novel classification system for subaxial cervica...


    pub_type: 杂志文章,评审


    authors: Vaccaro AR,Hulbert RJ,Patel AA,Fisher C,Dvorak M,Lehman RA Jr,Anderson P,Harrop J,Oner FC,Arnold P,Fehlings M,Hedlund R,Madrazo I,Rechtine G,Aarabi B,Shainline M,Spine Trauma Study Group.

    更新日期:2007-10-01 00:00:00

  • Controlled hypotensive anesthesia during spinal surgery. A retrospective study.

    abstract::A retrospective study has been made of 264 posterior spinal fusions performed between 1972 and 1978 at the Good Samaritan Hospital in Cincinnati. Two hundred ten of the procedures were performed under hypotensive anesthesia. Blood loss and total blood replacement were related to the mean arterial pressure (MAP) during...


    pub_type: 杂志文章


    authors: Lawhon SM,Kahn A 3rd,Crawford AH,Brinker MS

    更新日期:1984-07-01 00:00:00

  • Different arm positions and the shape of the thoracic spine can explain contradictory results in the literature about spinal loads for sitting and standing.

    abstract:STUDY DESIGN:Loads acting in vivo on a vertebral body replacement (VBR) and the shape of the back were measured. OBJECTIVE:To find an explanation for the contradictory results in literature regarding spinal loads for sitting and standing. SUMMARY OF BACKGROUND DATA:In several in vivo studies, the intradiscal pressure...


    pub_type: 杂志文章


    authors: Dreischarf M,Bergmann G,Wilke HJ,Rohlmann A

    更新日期:2010-10-15 00:00:00

  • The role of torsion in cervical spine trauma.

    abstract::A dynamic servocontrolled torsion machine has been used to characterize cervical injury due to pure rotation of the head. Resultant force moment, torque, and applied rotation have been measured. Torque applied to the base of the skull resulted in injury to the atlantoaxial joint. No evidence of lower cervical injury w...


    pub_type: 杂志文章


    authors: Myers BS,McElhaney JH,Doherty BJ,Paver JG,Gray L

    更新日期:1991-08-01 00:00:00

  • Electromagnetic field-based image-guided spine surgery part one: results of a cadaveric study evaluating lumbar pedicle screw placement.

    abstract:STUDY DESIGN:Human cadaveric. OBJECTIVES:Compare the accuracy of electromagnetic field (EMF)-based image-guided lumbar pedicle screw insertion to conventional techniques using anatomic landmarks, and fluoroscopy. BACKGROUND:Image-guided surgical systems that aid in spinal instrumentation seek to minimize radiation ex...


    pub_type: 杂志文章


    authors: Sagi HC,Manos R,Benz R,Ordway NR,Connolly PJ

    更新日期:2003-09-01 00:00:00

  • Lumbar and lumbosacral fusions using Cotrel-Dubousset pedicle screws and rods.

    abstract::The first 50 consecutive patients stabilized with Cotrel-Dubousset rods for lumbar or lumbosacral fusions were followed for an average of 2 years. The occurrence of fusion, maintenance of alignment, and rate of hardware complications were examined. There were 28 men and 22 women, ages 18-87 years, and 133 vertebral le...


    pub_type: 杂志文章


    authors: Mac Millan MM,Cooper R,Haid R

    更新日期:1994-02-15 00:00:00

  • Symptomatic spinal arachnoid cysts: report of two cases with review of the literature.

    abstract:STUDY DESIGN:Two unusual cases of intradural extramedullary noncommunicating arachnoid cysts are presented, with a review of literature. OBJECTIVE:To assess surgical excision results in the reversal of symptoms and neurologic deficits. SUMMARY OF BACKGROUND DATA:Most patients harboring arachnoid cysts are asymptomati...


    pub_type: 杂志文章,评审


    authors: Kumar K,Malik S,Schulte PA

    更新日期:2003-01-15 00:00:00

  • Can infant malnutrition cause adult vertebral stenosis?

    abstract::Does infant malnutrition produce smaller adult spinal canals? Lumbar and thoracic vertebrae (n X 1073), from a prehistoric American Indian population (15-55 yrs of age), were measured for anteroposterior (AP) and transverse (TR) vertebral canal sizes, nerve root tunnel (intervertebral foramen) widths (NRT), vertebral ...


    pub_type: 杂志文章


    authors: Clark GA,Panjabi MM,Wetzel FT

    更新日期:1985-03-01 00:00:00

  • Canal geometry changes associated with axial compressive cervical spine fracture.

    abstract:STUDY DESIGN:A laboratory study using isolated ligamentous human cadaveric cervical spines to investigate canal occlusion during (transient) and after (steady-state) axial compressive fracture. OBJECTIVES:To determine whether differences exist between transient and postinjury canal occlusion under axial compressive lo...


    pub_type: 杂志文章


    authors: Carter JW,Mirza SK,Tencer AF,Ching RP

    更新日期:2000-01-01 00:00:00

  • Thoracoscopic Vertebral Body Tethering for Adolescent Idiopathic Scoliosis: Follow-up Curve Behavior According to Sanders Skeletal Maturity Staging.

    abstract:STUDY DESIGN:Retrospective analysis of prospectively collected data. OBJECTIVE:To report the follow-up curve behaviors in different Sanders staging groups. SUMMARY OF BACKGROUND DATA:Vertebral body tethering (VBT) is a growth modulation technique that allows gradual spontaneous follow-up curve correction as the patie...


    pub_type: 杂志文章


    authors: Alanay A,Yucekul A,Abul K,Ergene G,Senay S,Ay B,Cebeci BO,Yalinay Dikmen P,Zulemyan T,Yavuz Y,Yilgor C

    更新日期:2020-11-15 00:00:00

  • Treatment of unstable thoracolumbar and lumbar spine injuries using Cotrel-Dubousset instrumentation.

    abstract:STUDY DESIGN:In this prospective study, the results of treating unstable thoracolumbar and lumbar injuries with Cotrel-Dubousset instrumentation were investigated. OBJECTIVE:To determine the pain and work status of the patients, to evaluate neurologic status, and to assess the efficacy of instrumentation in the short ...


    pub_type: 杂志文章


    authors: Katonis PG,Kontakis GM,Loupasis GA,Aligizakis AC,Christoforakis JI,Velivassakis EG

    更新日期:1999-11-15 00:00:00

  • The spondylolytic vertebra and its adjacent segment. Mobility measured before and after posterolateral fusion.

    abstract:STUDY DESIGN:By using roentgen stereophotogrammetric analysis in six patients having tantalum indicators implanted at a preoperative external fixation test, the mobility in the spondylolytic lumbosacral level and its adjacent segment could be studied before fusion and during the course of postoperative fusion consolida...


    pub_type: 杂志文章


    authors: Axelsson P,Johnsson R,Strömqvist B

    更新日期:1997-02-15 00:00:00

  • Finite element applications in human cervical spine modeling.

    abstract::The authors present a comprehensive state-of-the-art and critical review of the finite element models of the human cervical spine. They also focused on the developments in model construction (geometry generation), constitutive law (material property) identification, loading and boundary condition details, and validati...


    pub_type: 杂志文章,评审


    authors: Yoganandan N,Kumaresan S,Voo L,Pintar FA

    更新日期:1996-08-01 00:00:00

  • Histological study of chordoma origin from fetal notochordal cell rests.

    abstract:STUDY DESIGN:The histological comparative study was performed on chordoma and notochordal cell rests (NCRs). OBJECTIVE:To understand the histological similarity and homology of chordoma and NCRs, further supplying direct evidence of chordoma origin from NCRs. SUMMARY OF BACKGROUND DATA:Although many studies supported...


    pub_type: 杂志文章


    authors: Shen J,Shi Q,Lu J,Wang DL,Zou TM,Yang HL,Zhu GQ

    更新日期:2013-12-01 00:00:00

  • Scoliosis after median sternotomy in children with congenital heart disease.

    abstract:STUDY DESIGN:A retrospective review of spinal deformity in patients with congenital heart disease surgically treated through a median sternotomy before the age of 8 years. Assessment was done on chest roentgenograms at skeletal maturity. OBJECTIVES:To determine if patients surgically treated through a median sternotom...


    pub_type: 杂志文章


    authors: Ruiz-Iban MA,Burgos J,Aguado HJ,Diaz-Heredia J,Roger I,Muriel A,Sanchez PA

    更新日期:2005-04-15 00:00:00

  • Electrochemotherapy to Metastatic Spinal Melanoma: A Novel Treatment of Spinal Metastasis?

    abstract:STUDY DESIGN:Preliminary report of new antitumor treatment. OBJECTIVE:To evaluate the effectiveness of electrochemotherapy as a novel treatment of spinal metastasis. SUMMARY OF BACKGROUND DATA:Electrochemotherapy is a new antitumor treatment that combines systemic bleomycin with electric pulses delivered locally at t...


    pub_type: 杂志文章


    authors: Gasbarrini A,Campos WK,Campanacci L,Boriani S

    更新日期:2015-12-01 00:00:00

  • Smokers show less improvement than nonsmokers two years after surgery for lumbar spinal stenosis: a study of 4555 patients from the Swedish spine register.

    abstract:STUDY DESIGN:A cohort study based on the Swedish Spine Register. OBJECTIVE:To determine the relation between smoking status and disability after surgical treatment for lumbar spinal stenosis. SUMMARY OF BACKGROUND DATA:Smoking and nicotine have been shown to inhibit lumbar spinal fusion and promote disc degeneration....


    pub_type: 杂志文章


    authors: Sandén B,Försth P,Michaëlsson K

    更新日期:2011-06-01 00:00:00

  • Radicular pain after vertebroplasty: compression or irritation of the nerve root? Initial experience with the "cooling system".

    abstract:STUDY DESIGN:During vertebroplasty (VP), polymethylmethacrylate (PMMA) may leak into the posterior epidural venus plexus, provoking symptoms ranging from radicular pain to medullar compression. OBJECTIVES:To propose and test the feasibility of a procedure (cooling system) to prevent radicular irritation caused by fora...


    pub_type: 杂志文章


    authors: Kelekis AD,Martin JB,Somon T,Wetzel SG,Dietrich PY,Ruefenacht DA

    更新日期:2003-07-15 00:00:00

  • Relative safety of anterior microsurgical decompression versus laminoplasty for cervical myelopathy with a massive ossified posterior longitudinal ligament.

    abstract:STUDY DESIGN:A retrospective clinical study was conducted. OBJECTIVE:To investigate the relative safety of anterior microsurgical decompression with iliac strut graft fusion versus laminoplasty for a massive ossified posterior longitudinal ligament in the cervical spine. SUMMARY OF BACKGROUND DATA:The question of how...


    pub_type: 杂志文章


    authors: Tani T,Ushida T,Ishida K,Iai H,Noguchi T,Yamamoto H

    更新日期:2002-11-15 00:00:00

  • Mechanical stability of the AO internal spinal fixation system compared with that of the Hartshill rectangle and sublaminar wiring in the management of unstable burst fractures of the thoracic and lumbar spine.

    abstract:STUDY DESIGN:A radiographic comparison of the mechanical efficacy of the Hartshill rectangle and that of the AO internal spinal skeletal fixation systems in the management of unstable burst fractures of the thoracic and lumbar spine. OBJECTIVES:To study the restoration and maintenance of normal spinal anatomy after op...


    pub_type: 杂志文章


    authors: Cresswell TR,Marshall PD,Smith RB

    更新日期:1998-01-01 00:00:00

  • Holocord astrocytoma: a two-staged operative approach.

    abstract::Biopsy or subtotal resection followed by radiation for intramedullary astrocytomas of the spinal cord offer palliation but not cure. A treatment modality using an ultrasonic suction device has revolutionized the treatment of these tumors and has been extended to include the treatment of intramedullary tumors involving...


    pub_type: 杂志文章


    authors: Benzel EC,Mirfarkhraee M,Hadden T,Fowler M

    更新日期:1987-10-01 00:00:00

  • New vertebral body impactors for posterolateral decompression of burst fracture.

    abstract::A new type of impactor was developed to decompress the anterior aspect of the vertebral body. These instruments are particularly useful for cases of burst fracture. ...


    pub_type: 杂志文章


    authors: Mimatsu K,Katoh F,Kawakami N

    更新日期:1993-08-01 00:00:00

  • Cost-effectiveness of lumbar spine radiography in primary care patients with low back pain.

    abstract:STUDY DESIGN:Fifty-two practices in the East Midlands, United Kingdom, were included. OBJECTIVES:To test the hypothesis that referral for lumbar spine radiography is cost-effective in primary care patients with low back pain of at least 6 weeks' duration compared with usual care in which referral is not routine. SUMM...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Miller P,Kendrick D,Bentley E,Fielding K

    更新日期:2002-10-15 00:00:00