RESUMEN
Benign lesions of the spine include benign tumors and tumor-like lesions of the spine, which usually occur in the thoracic and lumbar vertebrae. The incidence rate is low, accounting for about 1% of primary bone tumors. Few cases of endoscopic treatment of benign spinal lesions have been reported in the literature. Here, we introduce a new surgical technique using full endoscopy and allogeneic bone grafting to treat benign spinal lesions. All patients in this study successfully underwent the operation, and their pain was significantly relieved postoperatively. The patient VAS scores decreased from 3.07 ± 0.70 preoperatively to 0.33 ± 0.49 at the last follow-up visit (p < 0.05). The mean total blood loss (including drainage blood) was 16.67 ± 6.98 mL. The mean operative time was 63.33 ± 7.23 min. No patients developed numbness in the corresponding segmental distribution after surgery, none of the patients had serious postoperative complications, and none had focal recurrence during follow-up requiring reoperation. Patients reported symptom relief throughout the whole follow-up period. We believe that endoscopic surgery preserves the ligaments and soft tissues around the vertebral body, and that this technique is feasible with minimal trauma, rapid recovery, and good outcomes at short-term follow-up. This minimally invasive treatment modality offers a new option for the treatment of patients with benign spinal lesions.
RESUMEN
OBJECTIVE: To compare the efficacy of recombinant human bone morphogenetic proteins (rhBMPs) and autologous bone graft (ABG) on the healing of long bone non-union. METHODS: A systematic literature search was conducted on PubMed, Web of Science, Cochrane Library, and CNKI up to December 2021. Two authors independently screened the studies, extracted data, and assessed the quality of the trials. A Meta-analysis was performed using state software (version 12.0). RESULTS: A total of 14 studies were included in this meta-analysis. Overall, there was no significant difference between the rhBMPs group and the ABG group in terms of healing rate (RR = 1.04, 95% CI = 0.96-1.12, p = 0.365) and healing time (SMD = -0.31, 95% CI = -0.76-0.14, p = 0.175). Subgroup analysis showed rhBMPs lead to higher healing rates (RR = 1.35, 95% CI = 1.17-1.56, p < 0.001), and shorter healing time (SMD = -0.65, 95% CI = -1.08 to -0.22, p = 0.003) in the subgroup of moderate-quality studies. Sensitivity analysis proved that our conclusions were relatively robust. No significant publication bias was recognized in all studies (Begg's test, p = 0.193; Egger's test, p = 0.307). CONCLUSIONS: RhBMPs or combined with allografts bone, inorganic bone was a valid alternative to ABG for the treatment of long bone non-union.
Asunto(s)
Trasplante Óseo , Cicatrización de Heridas , Humanos , Proteínas Morfogenéticas ÓseasRESUMEN
Background/aim: This study was performed to show the efficacy of in situ local autograft with a comparison of in situ local autograft, local autograft with allograft, and local autograft with posterior iliac crest autograft.Materials and methods: In this prospective randomized study, a total of 65 adolescent idiopathic scoliosis (AIS) patients were separated into 3 groups: Group 1 using local autograft and allograft, Group 2 using local autograft only, and Group 3 using local autograft and posterior iliac crest autograft. Posterior segmental instrumentation was also applied to all patients. The mean follow-up period was 28.5 months (range, 15-40 months). Pseudarthrosis was investigated with the multiplanar and three-dimensional images obtained using multislice computed tomography, thoracolumbar bone single-photon emission computed tomography, and three-phase regional and whole body bone scintigraphy. Results: Pseudarthrosis was not observed in any patient. Fusion was obtained in all patients at the end of the follow-up periods.Conclusion: Similar results were obtained in respect of fusion in all 3 groups. Without the use of additional grafts, sufficient fusion can be achieved with the use of local autograft alone for posterior spinal fusion in patients with AIS.