PROGRESS AND CLINICAL APPLICATION OF ALLOGRAFT BONE SPACER IN CERVICAL AND LUMBAR INTERBODY FUSION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

PANJiancheng ¹ , GONGXu ¹ ,  LUOFei ²

1. Department of Spine and Joint Surgery, No. 181 Hospital of Chinese PLA, Guilin Guangxi, 541002, P. R. China;
2. Department of Orthopedics, National and Regional United Laboratory of Tissue Engineering, the Third Military Medical University, Guilin Guangxi, 541002, P. R. China;

Corresponding author：

LUOFei, Email: luofly1009@hotmail.com

Keywords：

Allograft bone; Interbody fusion; Interbody spacer

DOI：

10.7507/1002-1892.20150080

Video：

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Objective To review the research progress and clinical application of allograft bone spacer in cervical and lumbar interbody fusion. Methods Literature about allograft bone spacer in cervical and lumbar degenerative disease was reviewed and analyzed, including the advantages and disadvantages of allograft material, fusion rate, effectiveness, and complications. Results Fusion rate and effectiveness of allograft bone spacers were similar to those of autograft and polyetheretherketone spacers, and they were recommended by many orthopedists. However, indications, long-term effectiveness, and complications were not clear. Conclusion Further study on allograft bone spacer in cervical and lumbar interbody fusion should be focused on optimal indications and long-term effectiveness.

Citation： PANJiancheng, GONGXu, LUOFei. PROGRESS AND CLINICAL APPLICATION OF ALLOGRAFT BONE SPACER IN CERVICAL AND LUMBAR INTERBODY FUSION. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(3): 381-385. doi: 10.7507/1002-1892.20150080 Copy

1.	Humphreys SC, Hodges SD, Patwardhan AG, et al. Comparison of posterior and transforaminal approaches to lumbar interbody fusion. Spine (Phila Pa 1976), 2001, 26 (5):567-571.
2.	Groth AT, Kuklo TR, Klemme WR, et al. Comparison of sagittal contour and posterior disc height following interbody fusion:threaded cylindrical cages versus structural allograft versus vertical cages. J Spinal Disord Tech, 2005, 18(4):332-336.
3.	DiPaola CP, Molinari RW. Posterior lumbar interbody fusion. J Am Acad Orthop Surg, 2008, 16(3):130-139.
4.	Kuslich SD, Bagby G. The BAK interbody fusion system:early clinical results of treatment for chronic low back pain. 8th NASS Annual Meeting. San Diego, 1993:175-176.
5.	Wang X, Chen Y, Chen D, et al. Anterior decompression and interbody fusion with BAK/C for cervical disc degenerative disorders. J Spinal Disord Tech, 2009, 22(4):240-245.
6.	Costi JJ, Freeman BJ, Elliott DM. Intervertebral disc properties:challenges for biodevices. Expert Rev Med Devices, 2011, 8(3):357-376.
7.	周春光, 宋跃明, 刘浩, 等. 可降解椎间融合器的研究进展. 中国修复重建外科杂志, 2010, 24(12):1500-1505.
8.	卢畅, 杨明. 可吸收椎间融合器的研究进展. 临床医学研究, 2008, 25(11):2091-2093.
9.	Lee JH, Lee JH, Park JW, et al. Fusion rates of a morselized local bone graft in polyetheretherketone cages in posterior lumbar interbody fusion by quantitative analysis using consecutive three-dimensional computed tomography scans. Spine J, 2011, 11(7):647-653.
10.	Herkowitz HN, Sidhu KS. Lumbar spine fusion in the treatment of degenerative conditions:current indications and recommendations. J Am Acad Orthop Surg, 1995, 3(3):123-135.
11.	Lowe TG, Tahernia AD, O'Brien MF, et al. Unilateral transforaminal posterior lumbar interbody fusion (TLIF):indications, technique, and 2-year results. J Spinal Disord Tech, 2002, 15(1):31-38.
12.	O'Brien JP, Holte DC. Simultaneous combined anterior and posterior fusion. A review of its concept and 10 years of refinement of the technique:a solution for the patient with severe back and leg pain. Eur Spine J, 1992, 1(1):2-6.
13.	Liljenqvist U, O'Brien JP, Renton P. Simultaneous combined anterior and posterior lumbar fusion with femoral cortical allograft. Eur Spine J, 1998, 7(2):125-131.
14.	Sarwat AM, O'Brien JP, Renton P, et al. The use of allograft (and avoidance of autograft) in anterior lumbar interbody fusion:a critical analysis. Eur Spine J, 2001, 10(3):237-241.
15.	Gazdag AR, Lane JM, Glaser D, et al. Alternatives to autogenous bone graft:efficacy and indications. J Am Acad Orthop Surg, 1995, 3(1):1-8.
16.	Beranek J, Tomek A, Lorinson D. Distraction-stabilisation of two adjacent intervertebral spaces in a Dalmatian dog with caudal cervical spondylomyelopathy. Schweiz Arch Tierheilkd, 2013, 155(5):299-303.
17.	Janssen ME, Lam C, Beckham R. Outcomes of allogenic cages in anterior and posterior lumbar interbody fusion. Eur Spine J, 2001, 10 Suppl 2:S158-168.
18.	Slosar PJ, Josey R, Reynolds J. Accelerating lumbar fusions by combining rhBMP-2 with allograft bone:a prospective analysis of interbody fusion rates and clinical outcomes. Spine J, 2007, 7(3):301-307.
19.	Suchomel P, Barsa P, Buchvald P, et al. Autologous versus allogenic bone grafts in instrumented anterior cervical discectomy and fusion:a prospective study with respect to bone union pattern. Eur Spine J, 2004, 13(6):510-515.
20.	Barnes B, Rodts GE Jr, Haid RW Jr, et al. Allograft implants for posterior lumbar interbody fusion:results comparing cylindrical dowels and impacted wedges. Neurosurgery, 2002, 51(5):1191-1198.
21.	Arnold PM, Robbins S, Paullus W, et al. Clinical outcomes of lumbar degenerative disc disease treated with posterior lumbar interbody fusion allograft spacer:a prospective, multicenter trial with 2-year follow-up. Am J Orthop, 2009, 38(7):E115-122.
22.	李洋, 罗飞, 刘鹏, 等. 新型后路同种异体骨解剖形腰椎融合器的疗效. 实用医学杂志, 2014, 30(7):105-108.
23.	Lee JH, Lee JH, Yoon KS, et al. Comparative study of unilateral and bilateral cages with respect to clinical outcomes and stability in instrumented posterior lumbar interbody fusion. Neurosurgery, 2008, 63(1):109-113.
24.	Villavicencio AT, Burneikiene S, Roeca CM, et al. Minimally invasive versus open transforaminal lumbar interbody fusion. Surg Neurol Int, 2010, 1:12.
25.	Culter AR, Siddiqui S, Mohan AL, et al. Comparison of polyetheretherketone cages with femoral cortical bone allograft as a single-piece interbody spacer in transforaminal lumbar interbody fusion. J Neurosurg Spine, 2006, 5(6):534-539.
26.	Bevevino AJ, Kang DG, Lehman RA Jr, et al. Systematic review and meta-analysis of minimally invasive transforaminal lumbarinterbody fusion rates performed without posterolateral fusion. J Clin Neurosci, 2014, 21(10):1686-1690.
27.	Oh HS, Shim CS, Kim JS, et al. Clinical and radiological comparison of femur and fibular allografts for the treatment of cervical degenerative disc diseases. J Korean Neurosurg Soc, 2013, 53(1):6-12.
28.	Sievänen H, Koskue V, Rauhio A, et al. Peripheral quantitative computed tomography in human long bones:evaluation of in vitro and in vivo precision. J Bone Miner Res, 1998, 13(5):871-882.
29.	Hacker RJ, Cauthen JC, Gilbert TJ, et al. A prospective randomized multicenter clinical evaluation of an anterior fusion cage. Spine (Phila Pa 1976), 2000, 25(20):2646-2654.
30.	Kayanja M, Orr RD. Incidence and outcome of graft resorption in anterior lumbar interbody fusion:using femoral ring allografts and recombinant human bone morphogenetic protein-2. Spine (Phila Pa 1976), 2014, 39(5):374-380.
31.	Kim YH, Park JW, Kim JS, et al. Long-term results and bone remodeling after THA with a short, metaphyseal-fitting anatomic cementless stem. Clin Orthop Relat Res, 2014, 472(3):943-950.

1. Humphreys SC, Hodges SD, Patwardhan AG, et al. Comparison of posterior and transforaminal approaches to lumbar interbody fusion. Spine (Phila Pa 1976), 2001, 26 (5):567-571.
2. Groth AT, Kuklo TR, Klemme WR, et al. Comparison of sagittal contour and posterior disc height following interbody fusion:threaded cylindrical cages versus structural allograft versus vertical cages. J Spinal Disord Tech, 2005, 18(4):332-336.
3. DiPaola CP, Molinari RW. Posterior lumbar interbody fusion. J Am Acad Orthop Surg, 2008, 16(3):130-139.
4. Kuslich SD, Bagby G. The BAK interbody fusion system:early clinical results of treatment for chronic low back pain. 8th NASS Annual Meeting. San Diego, 1993:175-176.
5. Wang X, Chen Y, Chen D, et al. Anterior decompression and interbody fusion with BAK/C for cervical disc degenerative disorders. J Spinal Disord Tech, 2009, 22(4):240-245.
6. Costi JJ, Freeman BJ, Elliott DM. Intervertebral disc properties:challenges for biodevices. Expert Rev Med Devices, 2011, 8(3):357-376.
7. 周春光, 宋跃明, 刘浩, 等. 可降解椎间融合器的研究进展. 中国修复重建外科杂志, 2010, 24(12):1500-1505.
8. 卢畅, 杨明. 可吸收椎间融合器的研究进展. 临床医学研究, 2008, 25(11):2091-2093.
9. Lee JH, Lee JH, Park JW, et al. Fusion rates of a morselized local bone graft in polyetheretherketone cages in posterior lumbar interbody fusion by quantitative analysis using consecutive three-dimensional computed tomography scans. Spine J, 2011, 11(7):647-653.
10. Herkowitz HN, Sidhu KS. Lumbar spine fusion in the treatment of degenerative conditions:current indications and recommendations. J Am Acad Orthop Surg, 1995, 3(3):123-135.
11. Lowe TG, Tahernia AD, O'Brien MF, et al. Unilateral transforaminal posterior lumbar interbody fusion (TLIF):indications, technique, and 2-year results. J Spinal Disord Tech, 2002, 15(1):31-38.
12. O'Brien JP, Holte DC. Simultaneous combined anterior and posterior fusion. A review of its concept and 10 years of refinement of the technique:a solution for the patient with severe back and leg pain. Eur Spine J, 1992, 1(1):2-6.
13. Liljenqvist U, O'Brien JP, Renton P. Simultaneous combined anterior and posterior lumbar fusion with femoral cortical allograft. Eur Spine J, 1998, 7(2):125-131.
14. Sarwat AM, O'Brien JP, Renton P, et al. The use of allograft (and avoidance of autograft) in anterior lumbar interbody fusion:a critical analysis. Eur Spine J, 2001, 10(3):237-241.
15. Gazdag AR, Lane JM, Glaser D, et al. Alternatives to autogenous bone graft:efficacy and indications. J Am Acad Orthop Surg, 1995, 3(1):1-8.
16. Beranek J, Tomek A, Lorinson D. Distraction-stabilisation of two adjacent intervertebral spaces in a Dalmatian dog with caudal cervical spondylomyelopathy. Schweiz Arch Tierheilkd, 2013, 155(5):299-303.
17. Janssen ME, Lam C, Beckham R. Outcomes of allogenic cages in anterior and posterior lumbar interbody fusion. Eur Spine J, 2001, 10 Suppl 2:S158-168.
18. Slosar PJ, Josey R, Reynolds J. Accelerating lumbar fusions by combining rhBMP-2 with allograft bone:a prospective analysis of interbody fusion rates and clinical outcomes. Spine J, 2007, 7(3):301-307.
19. Suchomel P, Barsa P, Buchvald P, et al. Autologous versus allogenic bone grafts in instrumented anterior cervical discectomy and fusion:a prospective study with respect to bone union pattern. Eur Spine J, 2004, 13(6):510-515.
20. Barnes B, Rodts GE Jr, Haid RW Jr, et al. Allograft implants for posterior lumbar interbody fusion:results comparing cylindrical dowels and impacted wedges. Neurosurgery, 2002, 51(5):1191-1198.
21. Arnold PM, Robbins S, Paullus W, et al. Clinical outcomes of lumbar degenerative disc disease treated with posterior lumbar interbody fusion allograft spacer:a prospective, multicenter trial with 2-year follow-up. Am J Orthop, 2009, 38(7):E115-122.
22. 李洋, 罗飞, 刘鹏, 等. 新型后路同种异体骨解剖形腰椎融合器的疗效. 实用医学杂志, 2014, 30(7):105-108.
23. Lee JH, Lee JH, Yoon KS, et al. Comparative study of unilateral and bilateral cages with respect to clinical outcomes and stability in instrumented posterior lumbar interbody fusion. Neurosurgery, 2008, 63(1):109-113.
24. Villavicencio AT, Burneikiene S, Roeca CM, et al. Minimally invasive versus open transforaminal lumbar interbody fusion. Surg Neurol Int, 2010, 1:12.
25. Culter AR, Siddiqui S, Mohan AL, et al. Comparison of polyetheretherketone cages with femoral cortical bone allograft as a single-piece interbody spacer in transforaminal lumbar interbody fusion. J Neurosurg Spine, 2006, 5(6):534-539.
26. Bevevino AJ, Kang DG, Lehman RA Jr, et al. Systematic review and meta-analysis of minimally invasive transforaminal lumbarinterbody fusion rates performed without posterolateral fusion. J Clin Neurosci, 2014, 21(10):1686-1690.
27. Oh HS, Shim CS, Kim JS, et al. Clinical and radiological comparison of femur and fibular allografts for the treatment of cervical degenerative disc diseases. J Korean Neurosurg Soc, 2013, 53(1):6-12.
28. Sievänen H, Koskue V, Rauhio A, et al. Peripheral quantitative computed tomography in human long bones:evaluation of in vitro and in vivo precision. J Bone Miner Res, 1998, 13(5):871-882.
29. Hacker RJ, Cauthen JC, Gilbert TJ, et al. A prospective randomized multicenter clinical evaluation of an anterior fusion cage. Spine (Phila Pa 1976), 2000, 25(20):2646-2654.
30. Kayanja M, Orr RD. Incidence and outcome of graft resorption in anterior lumbar interbody fusion:using femoral ring allografts and recombinant human bone morphogenetic protein-2. Spine (Phila Pa 1976), 2014, 39(5):374-380.
31. Kim YH, Park JW, Kim JS, et al. Long-term results and bone remodeling after THA with a short, metaphyseal-fitting anatomic cementless stem. Clin Orthop Relat Res, 2014, 472(3):943-950.

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