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The influence of intervertebral disc tissue on anterior spinal interbody fusion: an experimental study on pigs.
Li, Haisheng; Zou, Xuenong; Laursen, Malene; Egund, Niels; Lind, Martin; Bünger, Cody.
Afiliación
  • Li H; Orthopaedic Research Laboratory, Orthopaedic Department E, Aarhus University Hospital, Norrebrogade 44, 8000 Aarhus C. Denmark. haisheng.li@iekf.au.dk
Eur Spine J ; 11(5): 476-81, 2002 Oct.
Article en En | MEDLINE | ID: mdl-12384757
Intervertebral disc has been shown to be related to low back pain and nerve root injury in pathologic conditions. However, little is known about its influence on spinal fusion. With the development of minimal invasive operations, such as laparoscopic anterior spinal fusion with cages, insufficient discectomy may occur. With its inflammatory properties, the residue nucleus pulposus may have an effect on spinal fusion. In this study, a two-level lumbar spine interbody fusion (L3/4, L5/6) with a Brantigan cage was performed on ten Danish Landrace pigs. Each level was randomly assigned to one of the following methods: (1) implantation of Brantigan cage filled with autogenous iliac crest bone graft, or (2) implantation of Brantigan cage filled with a mixture of autograft and the nucleus pulposus tissue harvested from the disc level in which it was to be inserted. Each level was stabilized with two staples. The pigs were followed for 12 weeks in the same standardized condition. After sacrifice, the lumbar spines were taken out, and plain X-ray, computed tomographic (CT) scanning and histomorphometry were performed to study the fusion mass inside the cages. From plain radiographs, new bone formation could be seen inside and around the cage. CT evaluation showed that the nucleus pulposus level had a 20% (2/10) fusion rate, while the pure autograft level had a 70% (7/10) fusion rate ( P=0.07). The histological fusion rate was even lower in the nucleus pulposus level (10%), and was significantly different from the autograft level (70%, P=0.02). Histomorphometric parameters of new bone formation, bone marrow space and fibrous tissue differed significantly between the two levels ( P=0.04; P=0.02; P=0.04 respectively). We conclude that when nucleus pulposus is mixed with the autogenous bone graft, it can delay or decrease the bone formation inside the cage, thus influencing the final fusion.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fusión Vertebral / Trasplante Óseo / Discectomía Percutánea / Disco Intervertebral / Vértebras Lumbares Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies Límite: Animals Idioma: En Revista: Eur Spine J Asunto de la revista: ORTOPEDIA Año: 2002 Tipo del documento: Article Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fusión Vertebral / Trasplante Óseo / Discectomía Percutánea / Disco Intervertebral / Vértebras Lumbares Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies Límite: Animals Idioma: En Revista: Eur Spine J Asunto de la revista: ORTOPEDIA Año: 2002 Tipo del documento: Article Pais de publicación: Alemania