Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study inve...Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study investigated the efficacy of calcium sulfate by comparing the fusion rates between the experimental material (calcium sulfate pellets with bone chips from laminectomy) and autologous iliac bone graft in long segment (three-or four-level) lumbar and lumbosacral posterolateral fusion. Forty-five patients with degenerative scoliosis or spondylolisthesis received multilevel spine fusion and decompression. The experimental material of calcium sulfate pellets with decompression bone chips was placed on the experimental side and the iliac crest bone graft was placed on the control side. The fusion status was assessed radiographically at three-month intervals, and solid fusion was defined as a clear continuous intertransverse bony bridge at all levels. The average follow-up period was 34.4 months. Twenty-nine (64.4%) patients showed solid fusion on the experimental side and 39 (86.7%) patients on the control side. The overall fusion rate was 86.7%. A statistically significant relation was found between the two sides with the Kappa coefficient of agreement of 0.436. Compared to the control side, the fusion rate of experimental side is significantly reduced (p = 0.014). The fusion ability of autograft is higher than the experimental material in multilevel lumbar posterolateral fusion. However, the overall fusion rate of calcium sulfate pellets is improved, compared with previously reported rates, which suggested that such material may be considered as an acceptable bone graft extender.展开更多
Background：The treatment for long bone defects has been a hot topic in the field of regenerative medicine.This study aimed to evaluate the therapeutic effects of calcium sulfate （CS） combined with platelet-rich pla...Background：The treatment for long bone defects has been a hot topic in the field of regenerative medicine.This study aimed to evaluate the therapeutic effects of calcium sulfate （CS） combined with platelet-rich plasma （PRP） on long bone defect restoration.Methods：A radial bone defect model was constructed through an osteotomy using New Zealand rabbits.The rabbits were randomly divided into four groups （n =10 in each group）：a CS combined with PRP （CS-PRP） group,a CS group,a PRP group,and a positive （recombinant human bone morphogenetic protein-2） control group.PRP was prepared from autologous blood using a two-step centrifugation process.CS-PRP was obtained by mixing hemihydrate CS with PRP.Radiographs and histologic micrographs were generated.The percentage of bone regenerated bone area in each rabbit was calculated at 10 weeks.One-way analysis of variance was performed in this study.Results：The radiographs and histologic micrographs showed bone restoration in the CS-PRP and positive control groups,while nonunion was observed in the CS and PRP groups.The percentages of bone regenerated bone area in the CS-PRP （84.60 ± 2.87%） and positive control （52.21 ± 4.53%） groups were significantly greater than those in the CS group （12.34 ± 2.17%） and PRP group （16.52 ± 4.22%） （P 〈 0.001）.In addition,the bone strength of CS-PRP group （43.l 0 ± 4.10%） was significantly greater than that of the CS group （20.10 ± 3.70%） or PRP group （25.10 ± 2.10%） （P 〈 0.001）.Conclusion：CS-PRP functions as an effective treatment for long bone defects through stimulating bone regeneration and enhancing new bone strength.展开更多
文摘Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study investigated the efficacy of calcium sulfate by comparing the fusion rates between the experimental material (calcium sulfate pellets with bone chips from laminectomy) and autologous iliac bone graft in long segment (three-or four-level) lumbar and lumbosacral posterolateral fusion. Forty-five patients with degenerative scoliosis or spondylolisthesis received multilevel spine fusion and decompression. The experimental material of calcium sulfate pellets with decompression bone chips was placed on the experimental side and the iliac crest bone graft was placed on the control side. The fusion status was assessed radiographically at three-month intervals, and solid fusion was defined as a clear continuous intertransverse bony bridge at all levels. The average follow-up period was 34.4 months. Twenty-nine (64.4%) patients showed solid fusion on the experimental side and 39 (86.7%) patients on the control side. The overall fusion rate was 86.7%. A statistically significant relation was found between the two sides with the Kappa coefficient of agreement of 0.436. Compared to the control side, the fusion rate of experimental side is significantly reduced (p = 0.014). The fusion ability of autograft is higher than the experimental material in multilevel lumbar posterolateral fusion. However, the overall fusion rate of calcium sulfate pellets is improved, compared with previously reported rates, which suggested that such material may be considered as an acceptable bone graft extender.
文摘Background：The treatment for long bone defects has been a hot topic in the field of regenerative medicine.This study aimed to evaluate the therapeutic effects of calcium sulfate （CS） combined with platelet-rich plasma （PRP） on long bone defect restoration.Methods：A radial bone defect model was constructed through an osteotomy using New Zealand rabbits.The rabbits were randomly divided into four groups （n =10 in each group）：a CS combined with PRP （CS-PRP） group,a CS group,a PRP group,and a positive （recombinant human bone morphogenetic protein-2） control group.PRP was prepared from autologous blood using a two-step centrifugation process.CS-PRP was obtained by mixing hemihydrate CS with PRP.Radiographs and histologic micrographs were generated.The percentage of bone regenerated bone area in each rabbit was calculated at 10 weeks.One-way analysis of variance was performed in this study.Results：The radiographs and histologic micrographs showed bone restoration in the CS-PRP and positive control groups,while nonunion was observed in the CS and PRP groups.The percentages of bone regenerated bone area in the CS-PRP （84.60 ± 2.87%） and positive control （52.21 ± 4.53%） groups were significantly greater than those in the CS group （12.34 ± 2.17%） and PRP group （16.52 ± 4.22%） （P 〈 0.001）.In addition,the bone strength of CS-PRP group （43.l 0 ± 4.10%） was significantly greater than that of the CS group （20.10 ± 3.70%） or PRP group （25.10 ± 2.10%） （P 〈 0.001）.Conclusion：CS-PRP functions as an effective treatment for long bone defects through stimulating bone regeneration and enhancing new bone strength.
