Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2015; 82(2):119-125 | DOI: 10.55095/achot2015/017

Posterolaterální fúze u akutních zlomenin thorakolumbální páteře: porovnání demineralizované kostní hmoty a autologních kostních štěpůPůvodní práce

F. BAUMANN^*, W. KRUTSCH, C. PFEIFER, C. NEUMANN, M. NERLICH, M. LOIBL

Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany

INTRODUCTION:
Alternative fusion expanders are in clinical use for instrumented posterolateral fusion (PLF) to avoid donor site morbidity in autologous bone graft (ABG) harvesting. Purpose of this study was to evaluate demineralized bone matrix (DBM) in PLF as alternative to the gold standard of ABG in acute traumatic vertebral body fractures of the thoracolumbar spine.

MATERIAL AND METHODS:
We retrospectively identified 101 patients with acute traumatic vertebral body fractures of the thoracic and lumbar spine who were treated with instrumented PLF in our level one trauma center between 2005 and 2011. Patients with a primary paraplegia, osteodepriving disease or loss to follow-up had been excluded. Until August 2008, autologous bone graft harvested from the posterior iliac crest was used in PLF (control group n = 46). Starting September 2008, DBM was used as fusion expander in PLF (study group n = 16). Clinical and radiological evaluation was performed with a minimum follow-up of 18 months to assess the clinical and radiological outcome.

RESULTS:
We found a fusion rate of 94% in patients undergoing PLF with the use of DBM and 100% with the use of ABG. There was one major complication of deep infection in the DBM group and two cases of superficial wound infection in the ABG group. We discovered a trend of reduced operating time with the use of DBM.

CONCLUSIONS:
DBM leads to a similar fusion rate as the use of ABG in patients undergoing PLF for acute traumatic vertebral body fractures of the thoracic and lumbar spine. DBM is associated with reduced operating time.
Level of evidence III: case-control study

Klíčová slova: demineralized bone matrix instrumented posterolateral fusion, acute traumatic vertebral body fracture, thoracolumbar spine, autologous bone graft

Zveřejněno: 1. duben 2015  Zobrazit citaci