Artikel
Influence of demineralized bone matrix on clinical and radiological outcome in anterior cervical discectomy and fusion
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Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: Demineralized bone matrix (DBM) is being used to fill cages in cervical interbody fusion in order to reduce the non-fusion rates. However, comparative data is still missing. Our aim is to evaluate the influence of DBM on radiological and clinical outcome after anterior cervical discectomy and fusion (ACDF) with stand-alone PEEK cages.
Method: A retrospective age-, gender- and number of levels-matched pair analysis was performed on 200 patients, who underwent anterior cervical discectomy and fusion (ACDF) with stand-alone PEEK cages with a minimum follow-up of 12 months. In the study group, DBM was used as an osteogenic filling substance. Radiographic follow-up included static and flexion/extensionX-rays. Changes in the operated segments were measured and compared to radiographs directly after surgery. Clinical outcome was evaluated the EuroQOL questionnaire (EQ-5D).
Results: 45% of patients were female. Mean age was 55 years. Mean follow-up was 30 months. Fusion rate was higher in the control group (84% vs. 72%; p=0.06). Subsidence rate was higher in the study group (40% vs 19%, p=0.001). VAS Overall Health increased from 42 ± 25 to 72 ± 22 in the study group and from 41 ± 24 to 71 ± 22 in the control group (p=0.75).
Conclusions: Application of DBM for ACDF with stand-alone PEEK Cages may have a negative influence on fusion. There was a trend towards impaired fusion with DBM. This, however, did not reach statistical significance. Also, DBM application correlated with significantly higher subsidence rates. There was no influence on clinical outcome.