Acta Medica Iranica 2009. 47(5):393-397.

Bioactive Glass versus Autogenous Iliac Crest Bone Graft in Adolescent Idiopathic Scoliosis Surgery
Ebrahim Ameri, Hamid Behtash, Bahram Mobini, Farzad Omidi Kashani, Marzieh Nojomi

Abstract


Surgery on the skeleton frequently requires harvesting of autogenous bone graft from the pelvis, but this procedure often is complicated by problems. The purpose of this retrospective, comparative descriptive study was to compare the efficacy of metal-derived bioactive glass (Novabone) versus autogenous iliac crest bone graft in adolescent idiopathic scoliosis surgery. The study was carried out on forty cases (aged 14-20 years) with 55 total curves fused for AIS. Posterior spinal fusion was performed using local bone grafts combined with autogenous iliac crest bone graft in 20 patients (group 1), and combined with Novabone in another twenty ones (group 2). The patients were observed for a minimum of 24 months after surgery, with a mean postoperative observation time of 34.7 months. The results were assessed clinically and radiologically. In group 1, average preoperative curve was 66° with immediate correction to 24.2° (59.7%) and final follow-up of 27.4° (54.3%), but in group 2 the calculated numbers included 63.8°, 25.8° (59.6%) and 28.4° (55.5 %) respectively. There were 5 indeterminate fusions (3 cases in group 1 and 2 in the other group), 1 acute infection, and 1 hook dislodgement in the synthetic group. These results justify and favor the use of bone substitutes for instrumented posterior spinal fusion in AIS. Potentially hazardous harvesting of pelvic bone is no longer necessary for such operations.


Keywords


Bone graft; adolescent idiopathic scoliosis; spinal fusion; bone substitute

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References


Skaggs DL, Samuelson MA, Hale JM, Kay RM, Tolo VT. Complications of posterior iliac crest bone grafting in spine surgery in children. Spine (Phila Pa 1976) 2000; 25(18): 2400-2.

Knapp DR Jr, Jones ET, Blanco JS, Flynn JC, Price CT. Allograft bone in spinal fusion for adolescent idiopathic scoliosis. J Spinal Disord Tech 2005;18 Suppl:S73-6.

Jones KC, Andrish J, Kuivila T, Gurd A. Radiographic outcomes using freeze-dried cancellous allograft bone for posterior spinal fusion in pediatric idiopathic scoliosis. J Pediatr Orthop 2002;22(3):285-9.

Campbell DG, Li P, Oakeshott RD. HIV infection of human cartilage. J Bone Joint Surg Br 1996;78(1):22-5.

Tomford WW, Starkweather RJ, Goldman MH. A study of the clinical incidence of infection in the use of banked allograft bone. J Bone Joint Surg Am 1981;63(2):244-8.

Vaccaro AR, Chiba K, Heller JG, Patel TCh, Thalgott JS, Truumees E, et al. Bone grafting alternatives in spinal surgery. Spine J 2002;2(3):206-15.

Conejero JA, Lee JA, Ascherman JA. Cranial defect reconstruction in an experimental model using different mixtures of bioglass and autologous bone. J Craniofac Surg 2007;18(6):1290-5.

Wheeler DL, Stokes KE, Hoellrich RG, Chamberland DL, McLoughlin SW. Effect of bioactive glass particle size on osseous regeneration of cancellous defects. J Biomed Mater Res 1998;41(4):527-33.

Leatherman BD, Dornhoffer JL. Bioactive glass ceramic particles as an alternative for mastoid obliteration: results in an animal model. Otol Neurotol 2002;23(5):657-60.

Lovelace TB, Mellonig JT, Meffert RM, Jones AA, Nummikoski PV, Cochran DL. Clinical evaluation of bioactive glass in the treatment of periodontal osseous defects in humans. J Periodontol 1998;69(9):1027-35.

Elshahat A, Shermak MA, Inoue N, Chao EY, Manson P. The use of Novabone and Norian in cranioplasty: a comparative study. J Craniofac Surg 2004;15(3):483-9.

Delécrin J, Takahashi S, Gouin F, Passuti N. A synthetic porous ceramic as a bone graft substitute in the surgical management of scoliosis: a prospective, randomized study. Spine (Phila Pa 1976) 2000;25(5):563-9.

Hing KA, Wilson LF, Buckland T. Comparative performance of three ceramic bone graft substitutes. Spine J 2007;7(4):475-90.

Sengupta DK, Truumees E, Patel CK, Kazmierczak C, Hughes B, Elders G, et al. Outcome of local bone versus autogenous iliac crest bone graft in the instrumented posterolateral fusion of the lumbar spine. Spine (Phila Pa 1976) 2006;31(9):985-91.

Blount KJ, Krompinger WJ, Maljanian R, Browner BD. Moving toward a standard for spinal fusion outcomes assessment. J Spinal Disord Tech 2002;15(1):16-23.

Lauerman WC, Bradford DS, Transfeldt EE, Ogilvie JW. Management of pseudarthrosis after arthrodesis of the spine for idiopathic scoliosis. J Bone Joint Surg Am 1991;73(2):222-36.

Dawson EG, Clader TJ, Bassett LW. A comparison of different methods used to diagnose pseudarthrosis following posterior spinal fusion for scoliosis. J Bone Joint Surg Am 1985;67(8):1153-9.

Gibson S, McLeod I, Wardlaw D, Urbaniak S. Allograft versus autograft in instrumented posterolateral lumbar spinal fusion: a randomized control trial. Spine (Phila Pa 1976) 2002;27(15):1599-603.

Kant AP, Daum WJ, Dean SM, Uchida T. Evaluation of lumbar spine fusion. Plain radiographs versus direct surgical exploration and observation. Spine (Phila Pa 1976) 1995;20(21):2313-7.

Penta M, Fraser RD. Anterior lumbar interbody fusion. A minimum 10-year follow-up. Spine (Phila Pa 1976) 1997;22(20):2429-34.

Lenke LG, Bridwell KH, Baldus C, Blanke K, Schoenecker PL. Cotrel-Dubousset instrumentation for adolescent idiopathic scoliosis. J Bone Joint Surg Am 1992;74(7):1056-67.

Richards BS, Herring JA, Johnston CE, Birch JG, Roach JW. Treatment of adolescent idiopathic scoliosis using Texas Scottish Rite Hospital instrumentation. Spine (Phila Pa 1976) 1994;19(14):1598-605.

Mielke CH, Lonstein JE, Denis F, Vandenbrink K, Winter RB. Surgical treatment of adolescent idiopathic scoliosis. A comparative analysis. J Bone Joint Surg Am 1989;71(8): 1170-7.

Banwart JC, Asher MA, Hassanein RS. Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine (Phila Pa 1976) 1995;20(9):1055-60.

Catinella FP, De Laria GA, De Wald RL. False aneurysm of the superior gluteal artery. A complication of iliac crest bone grafting. Spine (Phila Pa 1976) 1990;15(12):1360-2.

Summers BN, Eisenstein SM. Donor site pain from the ilium. A complication of lumbar spine fusion. J Bone Joint Surg Br 1989;71(4):677-80.

Moss AL. The morbidity of harvesting bone from the iliac crest. Cleft Palate Craniofac J 2000;37(3):326.

Ransford AO, Morley T, Edgar MA, Webb P, Passuti N, Chopin D, et al. Synthetic porous ceramic compared with autograft in scoliosis surgery. A prospective, randomized study of 341 patients. J Bone Joint Surg Br 1998;80(1):13-8.

Price CT, Connolly JF, Carantzas AC, Ilyas I. Comparison of bone grafts for posterior spinal fusion in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2003;28(8):793-8.

Gosain AK; Plastic Surgery Educational Foundation DATA Committee. Bioactive glass for bone replacement in craniomaxillofacial reconstruction. Plast Reconstr Surg 2004;114(2):590-3.

Violas P, Chapuis M, Bracq H. Local autograft bone in the surgical management of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2004;29(2):189-92.


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