EFFECTIVENESS OF A NEW ALLOGRAFT BONE IN APPLICATION OF ANTERIOR CERVICAL OPERATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 HAOYingjie , ZHANGDi , LIZhilei , LIUTao , YULei , LIYing

Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan, 450052, P. R. China;

Corresponding author：

HAOYingjie, Email: haojack77@126.com

Keywords：

Allograft bone; Decellularization; Anterior cervical discectomy and fusion; Cervical spondylosis

DOI：

10.7507/1002-1892.20150123

Video：

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Objective To analyze the effectiveness of a new type of decellularized allogeneic bone in the application of anterior cervical discectomy and fusion (ACDF). Methods A retrospective analysis was made on the clinical data of 73 patients with single segmental cervical spondylosis treated with ACDF between January 2009 and December 2013. Of 73 cases, autologous iliac bone was used in 22 cases (group A), new decellularized allogeneic bone transplantation (Bio-Gene) in 22 cases (group B), and normal allogeneic bone (Xin Kang Chen) in 24 cases (group C). There was no significant difference in gender, age, type of cervical spondylosis, course of disease, and involved segment among 3 groups (P>0.05). The operation time, intraoperative blood loss, and complications were compared between groups; X-ray films and CT images were taken to observe the bone fusion, and Japanese Orthopaedic Association (JOA) score was used to assess the clinical efficacy. Results The operation time and intraoperative blood loss of group A were significantly more than those of groups B and C (P<0.05), but no significant difference was found between groups B and C (P>0.05). Pain and numbness at donor site occurred in 12 cases, and poor healing in 1 case of group A; red swelling and exudate were observed in 1 case of group B and in 6 cases of group C; and there was significant difference in complications among 3 groups (χ²=18.82, P=0.00). All patients were followed up 6-54 months (mean, 30 months). The graft fusion rate was 100% in groups A and B, and was 95.8% in group C, showing no significant difference (χ²=2.04, P=0.36). The JOA score at 6 months after operation were significantly improved when compared with preoperative score in 3 groups (P<0.05), but no significant difference was found among the 3 groups at preoperation and 6 months after operation (P>0.05). The excellent and good rates of groups A, B, and C were 90.9%, 88.9%, and 87.5% respectively, showing no significant difference (χ²=0.14, P=0.93). Conclusion New type of decellularized allogeneic bone in ACDF has the advantages of shorter operation time, less blood loss, and better early effectiveness. But whether there is a chronic rejection or delayed rejection needs further studies.

Citation： HAOYingjie, ZHANGDi, LIZhilei, LIUTao, YULei, LIYing. EFFECTIVENESS OF A NEW ALLOGRAFT BONE IN APPLICATION OF ANTERIOR CERVICAL OPERATION. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(5): 567-571. doi: 10.7507/1002-1892.20150123 Copy

1.	王义生. 脊柱融合术与非融合术不是相互替代而是互补. 中国脊柱脊髓杂志, 2011, 21(1):7-8.
2.	袁文. 脊柱非融合技术是融合术的终结者吗? 中国脊柱脊髓杂志, 2008, 18(1):11-12.
3.	宋会平, 王志强. 异体骨的临床应用. 中国修复重建外科杂志, 2006, 20(1):77-80.
4.	Czitrom AA, Axelrod T, Fernandes B. Antigen presenting cells and bone allotransplantation. Clin Orthop Relat Res, 1985, (197):27-31.
5.	陆军, 吴苏稼, 施鑫. 同种异体骨移植的免疫反应. 中国矫形外科杂志, 2002, 9(4):388-391.
6.	Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg Spine, 2007, 6(5):496-511.
7.	Smith GW, Robinson RA. The treatment of certain cervical spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg (Am), 1958, 40-A(3):607-624.
8.	Peolsson A, Vavruch L, Hedlund R. Long-term randomised comparison between a carbon fibre cage and the Cloward procedure in the cervical spine. Eur Spine J, 2007, 16(2):173-178.
9.	Jacobs W, Willems PC, Kruyt M, et al. Systematic review of anterior interbody fusion techniques for single-and double-level cervical degenerative disc disease. Spine (Phila Pa 1976), 2011, 36(14):E950-960.
10.	邱勇, 刘臻, 王斌, 等. 脊柱前路手术髂前嵴取骨并发症相关分析. 中国脊柱脊髓杂志, 2007, 17(8):584-587.
11.	程昌志, 林舟丹. 同种异体骨移植在颈椎前路融合手术中的应用. 中国组织工程研究与临床康复, 2007, 11(43):8765-8769.
12.	Samartzis D, Shen FH, Goldberg EJ, et al. Is autograft the gold standard in achieving radiographic fusion in one-level anterior cervical discectomy and fusion with rigid anterior plate fixation. Spine (Phila Pa 1976), 2005, 30(15):1756-1761.
13.	邱贵兴, 孙世荃. 同种异体骨植入材料的临床应用. 中华骨科杂志, 2004, 24(10):635-637.
14.	Graham SM, Leonidou A, Aslam-Pervez N, et al. Biological therapy of bone defects:the immunology of bone allo-transplantation. Expert Opin Biol Ther, 2010, 10(6):885-901.
15.	De Long WG Jr, Einhorn TA, Koval K, et al. Bone grafts and bone graft sub-stitutes in orthopaedic trauma surgery. J Bone Joint Surg (Am), 2007, 89(3):649-658.
16.	Yu HB, Shen GF, Wei FC. Effect of cryopreservation on the immunogenicity of osteoblasts. Transplant Proc, 2007, 39(10):3030-3031.
17.	Schreurs BW, Bolder SB, Gardeniers JW, et al. Acetabular revision with impacted morsellised cancellous bone grafting and a cemented cup. A 15- to 20-year follow-up. J Bone Joint Surg (Br), 2004, 86(4):492-497.
18.	朱加亮, 侯树勋, 衷鸿宾, 等. 脱脂程序对异体松质骨免疫原性影响的实验研究.中国矫形外科杂志, 2010, 18(9):762-767.
19.	陈振光, 祝少博, 郑晓晖. 带血管同种异体骨移植研究进展. 中华显微外科杂志, 2007, 30(4):249-253.
20.	徐麟皓, 王丽娜, 朱一苗, 等. 同种异体骨制备保存研究进展. 国际骨科学杂志, 2008, 29(5):320-321.

1. 王义生. 脊柱融合术与非融合术不是相互替代而是互补. 中国脊柱脊髓杂志, 2011, 21(1):7-8.
2. 袁文. 脊柱非融合技术是融合术的终结者吗? 中国脊柱脊髓杂志, 2008, 18(1):11-12.
3. 宋会平, 王志强. 异体骨的临床应用. 中国修复重建外科杂志, 2006, 20(1):77-80.
4. Czitrom AA, Axelrod T, Fernandes B. Antigen presenting cells and bone allotransplantation. Clin Orthop Relat Res, 1985, (197):27-31.
5. 陆军, 吴苏稼, 施鑫. 同种异体骨移植的免疫反应. 中国矫形外科杂志, 2002, 9(4):388-391.
6. Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg Spine, 2007, 6(5):496-511.
7. Smith GW, Robinson RA. The treatment of certain cervical spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg (Am), 1958, 40-A(3):607-624.
8. Peolsson A, Vavruch L, Hedlund R. Long-term randomised comparison between a carbon fibre cage and the Cloward procedure in the cervical spine. Eur Spine J, 2007, 16(2):173-178.
9. Jacobs W, Willems PC, Kruyt M, et al. Systematic review of anterior interbody fusion techniques for single-and double-level cervical degenerative disc disease. Spine (Phila Pa 1976), 2011, 36(14):E950-960.
10. 邱勇, 刘臻, 王斌, 等. 脊柱前路手术髂前嵴取骨并发症相关分析. 中国脊柱脊髓杂志, 2007, 17(8):584-587.
11. 程昌志, 林舟丹. 同种异体骨移植在颈椎前路融合手术中的应用. 中国组织工程研究与临床康复, 2007, 11(43):8765-8769.
12. Samartzis D, Shen FH, Goldberg EJ, et al. Is autograft the gold standard in achieving radiographic fusion in one-level anterior cervical discectomy and fusion with rigid anterior plate fixation. Spine (Phila Pa 1976), 2005, 30(15):1756-1761.
13. 邱贵兴, 孙世荃. 同种异体骨植入材料的临床应用. 中华骨科杂志, 2004, 24(10):635-637.
14. Graham SM, Leonidou A, Aslam-Pervez N, et al. Biological therapy of bone defects:the immunology of bone allo-transplantation. Expert Opin Biol Ther, 2010, 10(6):885-901.
15. De Long WG Jr, Einhorn TA, Koval K, et al. Bone grafts and bone graft sub-stitutes in orthopaedic trauma surgery. J Bone Joint Surg (Am), 2007, 89(3):649-658.
16. Yu HB, Shen GF, Wei FC. Effect of cryopreservation on the immunogenicity of osteoblasts. Transplant Proc, 2007, 39(10):3030-3031.
17. Schreurs BW, Bolder SB, Gardeniers JW, et al. Acetabular revision with impacted morsellised cancellous bone grafting and a cemented cup. A 15- to 20-year follow-up. J Bone Joint Surg (Br), 2004, 86(4):492-497.
18. 朱加亮, 侯树勋, 衷鸿宾, 等. 脱脂程序对异体松质骨免疫原性影响的实验研究.中国矫形外科杂志, 2010, 18(9):762-767.
19. 陈振光, 祝少博, 郑晓晖. 带血管同种异体骨移植研究进展. 中华显微外科杂志, 2007, 30(4):249-253.
20. 徐麟皓, 王丽娜, 朱一苗, 等. 同种异体骨制备保存研究进展. 国际骨科学杂志, 2008, 29(5):320-321.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF A NEW ALLOGRAFT BONE IN APPLICATION OF ANTERIOR CERVICAL OPERATION

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