Abstract
The use of autologous grafts for vertebral arthrodesis is associated with a number of complications that should be properly considered: pain at the harvesting site, increased blood loss, prolonged surgical time, and additional scar. Moreover, in many cases, the amount of autologous bone is insufficient. Novel materials, either natural or synthetic, are therefore needed to be used as bone substitutes in vertebral surgery. For this purpose, a number of synthetic materials have been developed, their characteristics varying considerably in terms of ostoinduction, osteoconduction, biomecanics, and cost.
In particular, clinical and experimental studies have highlighted the potential of demineralized bone matrix (DBM), alone or in combination with autologous grafts, and of collagenic mineralized matrix (Healos).
Aim of this study was the evaluation of the clinical value of these materials in vertebral surgery. We have analyzed a series of 60 patients who underwent vertebral arthrodesis by the addition of either DBM (30 cases) or Healos (30 cases).
Bone substitutes were used both in posterior-lateral arthrodeses (on one side, the other being treated with autologous graft as a control) and in intersomatic arthrodeses in association with titanium or carbon fiber scaffolds.
Patients were followed-up for a minimum 1-year interval, and evaluated with regard to clinical (Oswestry score, SF-36) and radiographic (static and dynamic X-rays, spiral CT, MRI) parameters. The area of arthrodesis was independently analyzed by three independent observers.
Clinical results showed the reliability of both materials as a tool for a stable arthrodesis, since they were found to be able to achieve results comparable to those obtained with autologous grafts in the control arm of the study.
The abstracts were prepared by Ms Grazia Gliozzi. Correspondence should be addressed to her at the Italian Orthopaedic Research Society, Laboratory for Pathophysiology, Instituti Ortopedici Rizzoli, University of Bologna, Bologna, Italy.
