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Clinical and radiographic evaluation of bioactive glass in posterior cervical and lumbar spinal fusion

  • Original Article • SPINE - BIOMATERIALS
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

Spinal surgery of degenerative painful segments is a valuable treatment option in the management of chronic cervical and low back pain. The surgery consists in stabilizing and fusing painful vertebral segment(s). The objective of the study was to report our experience with 45S5 bioactive glass (BAG) to obtain inter-vertebral fusion in the context of posterior spine surgery.

Material and method

In this retrospective study, 30 patients with a wide range of degenerative and traumatic conditions of the cervical or lumbar spine underwent spinal fusion utilizing a synthetic bone graft substitute of BAG (GlassBone™, Noraker, Lyon-Villeurbanne, France). The pain was evaluated by VAS score, and graft consolidation was assessed on according radiographic images at 1-year post-op.

Results

All patients underwent posterior spinal fusion either in the cervical or the thoraco-lumbar spine. Multi-level fusions represented the majority of the cohort (43% of patients with more than seven levels treated). Radiographic imaging demonstrated excellent fusion rates (93%) at final follow-up, equivalent to the outcomes reported in the literature for autogenous bone, with excellent bone bridging and no spinal implant loosening. Only two cases of non-union were encountered. Additionally, 90% of the patients demonstrated recovery at 1 year after surgery with a pain reduction of 60%.

Conclusion

The results of this retrospective study suggest that the 45S5 BAG may be an interesting alternative option to autologous graft, in terms of safety and bone fusion efficiency.

Level of evidence

IV Retrospective study

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References

  1. Boden SD (2002) Overview of the biology of lumbar spine fusion and principles for selecting a bone graft substitute. Spine 27:26–31

    Article  Google Scholar 

  2. Sandhu HS (2000) Anterior lumbar interbody fusion with osteoinductive growth factors. Clin Orthop Relat Res 371:56–60

    Article  Google Scholar 

  3. Yoon ST, Konopka JA, Wang JC, Youssef JA, Meisel HJ, Brodke DS, Park J-B (2017) ACDF graft selection by surgeons: survey of AOSpine members. Glob Spine J 7:410–416

    Article  Google Scholar 

  4. Fischer CR, Cassilly R, Cantor W, Edusei E, Hammouri Q, Errico T (2013) A systematic review of comparative studies on bone graft alternatives for common spine fusion procedures. Eur Spine J 22:1423–1435

    Article  Google Scholar 

  5. Chen F, He W, Mahaney K, Noeller J, Mhanna N, Viljoen S, Torner J, Hitchon P (2013) Alternative grafts in anterior cervical fusion. Clin Neurol Neurosurg 115:2049–2055

    Article  Google Scholar 

  6. Giannoudis PV, Dinopoulos H, Tsiridis E (2005) Bone substitutes: an update. Injury 36:S20–S27

    Article  Google Scholar 

  7. Midha S, Kim TB, van den Bergh W, Lee PD, Jones JR, Mitchell CA (2013) Preconditioned 70S30C bioactive glass foams promote osteogenesis in vivo. Acta Biomater 9:9169–9182

    Article  CAS  Google Scholar 

  8. Xynos ID, Edgar AJ, Buttery LD, Hench LL, Polak JM (2000) Ionic products of bioactive glass dissolution increase proliferation of human osteoblasts and induce insulin like growth factor II mRNA expression and protein synthesis. Biochem Biophys Res Commun 276:461–465

    Article  CAS  Google Scholar 

  9. Xynos ID, Edgar AJ, Buttery LD, Hench LL, Polak JM (2001) Gene-expression profiling of human osteoblasts following treatment with the ionic products of Bioglasst 45S5 dissolution. J Biomed Mater Res 55:151–157

    Article  CAS  Google Scholar 

  10. Guth K, Buckland T, Hing KA (2006) Silicon dissolution from microporous silicon substituted hydroxyapatite and its effect on osteoblast behaviour. Key Eng Mater 309:117–120

    Article  Google Scholar 

  11. Oonishi H, Kushitani S, Yasukawa E, Iwaki H, Hench LL, Wilson J, Tsuji E, Sugihara T (1997) Particulate bioglass compared with hydroxyapatite as a bone graft substitute. Clin Orthop Relat Res 334:316–325

    Article  Google Scholar 

  12. Hench LL (2013) An introduction to bioceramics. Imperial College Press, London

    Book  Google Scholar 

  13. Bergman SA et al (1995) Bone in-fill of non-healing calvarial defects using particulate bioglass and autogenous bone. Bioceramics 8:17–21

    CAS  Google Scholar 

  14. Cunningham BW, Oda I, Haggerty CJ, Buckley R, Goebel M, Fedder IL, McAfee PC (1998) The use of bioglass for spinal arthrodesis and iliac crest repair—an in vivo sheep model. In: Proceedings of the North American Society, pp 214–216

  15. Frantzen J, Rantakokko J, Aro HT, Heinänen J, Kajander S, Gullichsen E, Kotilainen E, Lindfors NC (2011) Instrumented spondylodesis in degenerative spondylolisthesis with bioactive glass and autologous bone: a prospective 11-year follow-up. J Spinal Disord Tech 24:455–461

    Article  Google Scholar 

  16. Ilharreborde B, Morel E, Fitoussi F, Presedo A (2008) Bioactive glass as a bone substitute for spinal fusion in adolescent idiopathic scoliosis: a comparative study with iliac crest autograft. J Pediatr Orthop 28:347–351

    Article  Google Scholar 

  17. Seddighi A, Seddighi AS, Zali AR, Afaghi V (2011) Study of the role of Nova Bone as a filling material in cervical cage in anterior fusion of cervical spine in patients with degenerative cervical disc disease. Glob J Health Sci 3:155–160

    Google Scholar 

  18. Ameri E, Behtash H, Mobini B, Omidi-Kashani F, Nojomi M (2007) Bioactive glass versus autogenous iliac crest bone graft in adolescent idiopathic scoliosis surgery. Acta Med Iran 47:41–45

    Google Scholar 

  19. Cammissa FP, Lowery G, Garfin SR, Geisler FH, Klara PM, McGuire RA, Sassard WR, Stubbs H, Block JE (2004) Two-year fusion rate equivalency between grafton DBM and autograft in posterolateral spine fusion. Spine 29:660–666

    Article  Google Scholar 

  20. Chen WJ, Tsai TT, Chen LH, Niu CC, Lai PL, Fu TS, McCarthy K (2005) The fusion rate of calcium sulfate with local autograft bone compared with autologous iliac bone graft for instrumented short segment spinal fusion. Spine 30:2293–2297

    Article  Google Scholar 

  21. Vaccaro AR, Anderson DG, Patel T, Fischgrund J, Truumees E, Herkowitz HN, Phillips F, Hilibrand A, Albert TJ, Wetzel T, McCulloch JA (2005) Comparison of op-1 putty (rhbmp-7) to iliac crest autograft for posterolateral lumbar arthrodesis. Spine 30:2709–2716

    Article  Google Scholar 

  22. Dimar JR, Glassman SD, Burkus KJ, Carreon LY (2006) Clinical outcomes and fusion success at 2 years of single-level instrumented posterolateral fusions with recombinant human bone morphogenic protein-2/compression resistant matrix versus iliac crest bone graft. Spine 31:2534–2539

    Article  Google Scholar 

  23. Frenandez-Fairen M, Sala P, Ramírez H, Gil J (2007) A prospective randomized study of unilateral versus bilateral instrumented posterolateral lumbar fusion in degenerative spondylolisthesis. Spine 32:395–401

    Article  Google Scholar 

  24. Guigui P, Blamoutier A (2005) Complications of surgical treatment of spinal deformities: a prospective multicentric study of 3311 patients. Revue De Chirurgie Orthopedique Et Reparatrice De L’Appareil Moteur 91:314–327

    Article  CAS  Google Scholar 

  25. Abdul-Jabbar A, Takemoto S, Weber MH, Hu SS, Mummaneni PV, Deviren V, Ames CP, Chou D, Weinstein PR, Burch S, Berven SH (2012) Surgical site infection in spinal surgery: description of surgical and patient-based risk factors for postoperative infection using administrative claims data. Spine 37:1340–1345

    Article  Google Scholar 

  26. Hench LL, Jones JR (2015) Bioactive glasses: frontiers and challenges. Front Bioeng Biotechnol 3:194

    Article  Google Scholar 

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Acknowledgements

The authors would like to thank Dr. Anthony L. B. Maçon and Ms Charlène Fort for their assistance in the revision of this paper.

Funding

It shall be mention that no funds were received in support of this study, and no benefits in any form have been and will be received from Noraker directly or indirectly towards the subject of this manuscript.

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Authors and Affiliations

  1. Department of Spine Surgery, P. Wertheimer University Hospital, Hospices Civils de Lyon, Claude Bernard University of Lyon 1, Lyon, France

    Cédric Barrey & Théo Broussolle

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  1. Cédric Barrey
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  2. Théo Broussolle
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Correspondence to Cédric Barrey.

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The author would like to declare a conflict of interest as he is a consultant for Noraker.

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Barrey, C., Broussolle, T. Clinical and radiographic evaluation of bioactive glass in posterior cervical and lumbar spinal fusion. Eur J Orthop Surg Traumatol 29, 1623–1629 (2019). https://doi.org/10.1007/s00590-019-02477-5

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  • DOI: https://doi.org/10.1007/s00590-019-02477-5

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