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Radiologischer Vergleich zweier Verfahren zur ventralen Spondylodese

Autologer trikortikaler Beckenkammspan vs. boviner Spongiosablock

Radiological comparison between two procedures for ventral spondylodesis

Autologous iliac crest bone graft vs bovine bone graft

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Zusammenfassung

Hintergrund

Die Spondylodese der Wirbelsäule mittels autologem Beckenkammspan ist ein Standardverfahren der Wirbelsäulenchirurgie. Zielsetzung dieser Untersuchung war die radiologische Evaluation der knöchernen Einheilung von autologen Beckenkammspänen und bovinen Spongiosablöcken nach Spondylodese anhand eines standardisierten Scores.

Material und Methode

Zwei Gruppen mit jeweils 9 Schafen erhielten eine ventrale Spondylodese mit einer winkelstabilen Platte, in der 1. Gruppe wurde ein autologer trikortikaler Beckenkammspan, in der 2. Gruppe ein boviner Spongiosaspan eingesetzt. 12 und 24 Wochen postoperativ erfolgte die radiologische Untersuchung mittels Computertomographie (CT). Die Beurteilung der knöchernen Einheilung erfolgte anhand des Tübinger Scores.

Ergebnisse

In der Auswertung der CT mittels Tübinger Score zeigte der autologe Beckenkammspan eine signifikant bessere Integration in das Spanlager als der bovine Spongiosablock.

Schlussfolgerung

Aufgrund der eigenen Ergebnisse wird man auch in Zukunft zur ventralen Spondylodese bovinen Spongiosablock als Transplantat nicht uneingeschränkt empfehlen können.

Abstract

Background

The objective of this study was the radiological evaluation of osseous integration of autologous iliac crest graft and bovine bone graft after spondylodesis based on a standardized score.

Material and methods

Spondylodesis was performed on 18 sheep, divided into 2 groups, 1 with an autologous iliac crest graft and the other with a bovine bone graft. Computed tomography was performed 12 and 24 weeks postoperatively. The osseous integration was assessed by the Tübinger Score.

Results

The evaluation of the CT scans demonstrated a significantly better osseous integration of the autologous iliac crest graft compared to the bovine bone graft.

Conclusions

Based on our results, the bovine bone graft as a transplant for spondylodesis is inadvisable.

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Literatur

  1. Badke A, Jedrusik P, Feiler M et al (2006) CT-based assessment score after ventral spondylodesis for thoracolumbar spine fracture. Unfallchirurg 109(2):119–124

    Article  PubMed  CAS  Google Scholar 

  2. Banwart JC, Asher MA, Hassanein RS (1995) Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine 20(9):1055–1060

    Article  PubMed  CAS  Google Scholar 

  3. Baramki HG, Papin P, Steffen T (2000) A surgical approach to the ventral aspect of the lumbar vertebrae in the sheep model. Surg Radiol Anat 22:25–27

    Article  PubMed  CAS  Google Scholar 

  4. Briem DRJ, Linhardt W (2003) Die Einheilung autogener Transplantate nach dorsoventraler Instrumentierung instabiler Frakturen der thorakolumbalen Wirbelsäule. Unfallchirurg 106:195–203

    Article  PubMed  CAS  Google Scholar 

  5. Bühren V (2003) Verletzungen der Brust- und Lendenwirbelsäule. Unfallchirurg 106:55–69

    Article  PubMed  Google Scholar 

  6. Dai L (2002) Low lumbar spinal fractures: management options. Injury 33:559–582

    Article  Google Scholar 

  7. Fritzell P, Hägg O, Wessberg P et al (2001) 2001 Volvo Award Winner in Clinical Studies: Lumbar fusion versus nonsurgical treatment fot chronic low back pain: A multicenter randomized controlled trial from the swedish lumbar spine study group. Spine 26(23):2521–2534

    Article  PubMed  CAS  Google Scholar 

  8. Flynn JC, Hoque MA (1979) Anterior fusion of the lumbar spine. End-result study with long-term follow-up. J Bone Joint Surg Am 61(8):1143–1150

    PubMed  CAS  Google Scholar 

  9. Hähnel H, Muschik M, Zippel H, Gutsche H (1991) Lumbar segmental spondylodesis–isolated ventral or combined dorsoventral? A comparison of results. Z Orthop Ihre Grenzgeb 129(2):197–203

    Article  PubMed  Google Scholar 

  10. Kossmann T, Ertel W, Platz A, Trentz O (1999) Combined surgery for fractures of the thoraco-lumbar junction using the inlay-span method. Orthopade 28(5):432–440

    PubMed  CAS  Google Scholar 

  11. Kossmann T, Jacobi D, Trentz O (2001) The use of a retractor system (SynFrame) for open, minimal invasive reconstruction of the anterior column of the thoracic and lumbar spine. Eur Spine J 10(5):396–402

    Article  PubMed  CAS  Google Scholar 

  12. Kubosch D, Milz S, Sprecher CM et al (2010) Effect of graft size on graft fracture rate after anterior lumbar spinal fusion in a sheep model. Injury 41(7):1048–1051

    Article  Google Scholar 

  13. Link TM, Lin JC, Newitt D et al (1998) Computer-assisted structure analysis of trabecular bone in the diagnosis of osteoporosis. Radiologe 38(10):853–859

    Article  PubMed  CAS  Google Scholar 

  14. Link TM, Majumdar S (2003) Osteoporosis imaging. Radiol Clin North Am 41(4):813–839

    Article  PubMed  Google Scholar 

  15. Maus U, Andereya S, Gravius S et al (2008) How to store autologous bone graft perioperatively: an in vitro study. Arch Orthop Trauma Surg 28:1461–1466

    Article  Google Scholar 

  16. McAfee PC, Boden SD, Brantigan JW et al (2001) Symposium: a critical discrepancy-a criteria of successful arthrodesis following interbody spinal fusions. Spine 26(3):320–334

    Article  PubMed  CAS  Google Scholar 

  17. Moll R, Schindler G, Weckbach A (2002) Evaluation of ventral stabilization techniques for thoracolumbar fractures by helical computer tomography. Rofo 174(7):880–886

    Article  PubMed  CAS  Google Scholar 

  18. Nichols TA, Sagi HC, Weber TG, Guiot BH (2008) An alternativ source of autograft bone for spinal fusion: the femur: a technical case report. Neurosurgery 62(3 Suppl 1):179

    Article  Google Scholar 

  19. Paar O, Andereya S, Staatz G et al (2001) Value of human recombinant osteogenetic proteins as bone replacement materials in lumbar spondylodesis. Results of an animal experiment study. Unfallchirurg 104(8):700–709

    Article  PubMed  CAS  Google Scholar 

  20. Prolo DJ, Oklund SA, Butcher M (1986) Toward uniformity in evaluating results of lumbar spine operations. A paradigm applied to posterior lumbar interbody fusions. Spine 11(6):601–606

    Article  PubMed  CAS  Google Scholar 

  21. Robert-Koch-Institut (1998) Bundes-Gesundheitssurvey. RKI, Berlin

  22. Robert-Koch-Institut (2006) Gesundheitsberichterstattung des Bundes. RKI, Berlin

  23. Sandu HS, Grewal HS, Parvataneni H (1999) Bone grafting for spinal fusion. Orthop Clin North Am 30:685–698

    Article  Google Scholar 

  24. Schnee CL, Freese A, Ansell LV (1997) Outcome analysis for adults with spondylolisthesis treated with posterolateral fusion and transpedicular screw fixation. J Neurosurg 86(1):56–63

    Article  PubMed  CAS  Google Scholar 

  25. Spivak JHA (2001) Use of hydroxyapatite in spine surgery. Eur Spine J 10:197–204

    Article  Google Scholar 

  26. Steffen T, Marchesi D, Aebi M (2000) Posterolateral and anterior interbody spinal fusion models in the sheep. Clin Orthop Relat Res 371:28–37

    Article  PubMed  Google Scholar 

  27. Strohm PC, Bley TA, Ghanem N et al (2006) Clinical and radiological findings after different treatment of odontoid fractures type Anderson II and III. Acta Chir Orthop Traumatol Cech 73(3):151–156

    PubMed  CAS  Google Scholar 

  28. Summers BES (1989) Donor site pain from the ilium: a complication of lumbar spine fusion. J Bone Joint Surg Am Br 71:677–680

    CAS  Google Scholar 

  29. Wilke HJ, Kettler A, Claes LE (1997) Are sheep spines a valid biomechanical model for human spine? Spine 22(20):2365–2374

    Article  PubMed  CAS  Google Scholar 

  30. Sheng SR, Wang XY, Xu HZ et al (2009) Anatomy of large animal spines and its comparison to the human spine: a systematic review. Eur Spine J 19(1):46–56

    Article  PubMed  Google Scholar 

  31. Younger EM, Chapman MW (1989) Morbidity at bone graft donor sites. J Orthop Trauma 3(3):192–195

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department für Orthopädie und Traumatologie, Universitätsklinikum Freiburg, Hugstetter Straße 49, 79106, Freiburg, Deutschland

    D. Kubosch, J. Rohr, K. Izadpanah, T.O. Hammer, N.P. Südkamp & P.C. Strohm

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  1. D. Kubosch
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  2. J. Rohr
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  3. K. Izadpanah
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  4. T.O. Hammer
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  5. N.P. Südkamp
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  6. P.C. Strohm
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Correspondence to D. Kubosch.

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Kubosch, D., Rohr, J., Izadpanah, K. et al. Radiologischer Vergleich zweier Verfahren zur ventralen Spondylodese. Unfallchirurg 115, 897–902 (2012). https://doi.org/10.1007/s00113-010-1945-y

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  • DOI: https://doi.org/10.1007/s00113-010-1945-y

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