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A prospective consecutive study of instrumented posterolateral lumbar fusion using synthetic hydroxyapatite (Bongros®‐HA) as a bone graft extender
Author(s) -
Lee Jae Hyup,
Hwang ChangJu,
Song ByungWook,
Koo KiHyung,
Chang BongSoon,
Lee ChoonKi
Publication year - 2008
Publication title -
journal of biomedical materials research part a
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 150
eISSN - 1552-4965
pISSN - 1549-3296
DOI - 10.1002/jbm.a.32113
Subject(s) - extender , medicine , spinal fusion , radiography , lumbar , iliac bone , surgery , materials science , nuclear medicine , composite material , polyurethane
A prospective, single institution, clinical case‐matched, radiographic study was undertaken. Thirty‐two patients underwent posterior lumbar interbody fusion with cages containing laminectomized bone chips and posterolateral lumbar fusion with pedicle screws. Autogenous bone graft (3 mL) plus 3 mL of hydroxyapatite was placed in one side of a posterolateral gutter, and 6 mL of autogenous iliac bone graft was placed on the other side. Bony union, volumes of fusion mass, and bone absorption rates were postoperatively evaluated using simple radiographs and 3D‐CT scans. Average postoperative Lenke scores at 3 and 6 months in the hydroxyapatite group were statistically higher than in the autograft group, but at 12 months no difference was found between the hydroxyapatite and autograft groups in terms of fusion rate. Complete fusion rates by 3D‐CT were 86.7% in the hydroxyapatite group and 88.9% in the autograft group, which are not significantly different. Volumes of fusion mass and bone absorption rates at 12 months were 2.35 mL in the hydroxyapatite group and 1.31 mL in the autograft group. The mean fusion mass volume was greater in the hydroxyapatite group than in the autograft group. Lumbar posterolateral fusion using a mixture of hydroxyapatite artificial bone and autogenous bone graft showed good bony union similar to that shown with autogenous bone only. This study suggests that hydroxyapatite bone chips could be used usefully as a bone‐graft extender in short‐segment posterolateral spinal fusion. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res, 2009