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Complications With Demineralized Bone Matrix, Hydroxyapatite and Beta-Tricalcium Phosphate in Single and Two-Level Anterior Cervical Discectomy and Fusion Surgery – Lumbar Fusion

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The article presents a systematic literature review analyzing complications in single or two-level anterior cervical discectomy and fusion (ACDF) using different types of graft materials. A total of 1857 patients were included in the review, with findings suggesting a higher incidence of adjacent segment disease and pseudoarthrosis in fusion constructs using demineralized bone matrix (DBM), while beta-tricalcium phosphate (β-TCP) was associated with higher rates of pseudoarthrosis and implant failures. The study highlights the need for further well-designed prospective studies to accurately assess the morbidity associated with each graft material in ACDF surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spinal clinic in London

Published article

S: Degenerative cervical conditions treated with one or two-level ACDF surgery using DBM, HA, or β-TCP with or without cervical plating are associated with complications such as adjacent segment disease, dysphagia, and pseudarthrosis. However, consequent to the study designs and clinical heterogeneity of the studies, it is not possible to correlate these complications accurately with any specific graft material employed. Further well-designed prospective studies are needed to correctly…

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Global Spine J. 2024 Feb;14(2_suppl):78S-85S. doi: 10.1177/21925682231157320.ABSTRACTSTUDY DESIGN: Systematic literature review.OBJECTIVES: To analyze the evidence available reporting complications in single or two-level anterior cervical discectomy and fusion (ACDF) using a demineralized bone matrix (DBM), hydroxyapatite (HA), or beta-tricalcium phosphate (β-TCP).METHODS: A systematic review of the literature using PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases was,

Global Spine J. 2024 Feb;14(2_suppl):78S-85S. doi: 10.1177/21925682231157320.

ABSTRACT

STUDY DESIGN: Systematic literature review.

OBJECTIVES: To analyze the evidence available reporting complications in single or two-level anterior cervical discectomy and fusion (ACDF) using a demineralized bone matrix (DBM), hydroxyapatite (HA), or beta-tricalcium phosphate (β-TCP).

METHODS: A systematic review of the literature using PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases was performed in August 2020 to identify studies reporting complications in one or two-level ACDF surgery using DBM, HA, or β-TCP. The study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

RESULTS: A total of 1857 patients were included, 981 male and 876 female, across 17 articles; 5 prospective, and 12 retrospectives. We noted heterogeneity among the included studies concerning the study design and combination of graft materials utilized in them. However, we noted a higher incidence of adjacent segment disease (17.7%) and pseudoarthrosis (9.3%) in fusion constructs using DBM. Studies using β-TCP reported a higher incidence of pseudoarthrosis (28.2%) and implant failures (17.9%).

S: Degenerative cervical conditions treated with one or two-level ACDF surgery using DBM, HA, or β-TCP with or without cervical plating are associated with complications such as adjacent segment disease, dysphagia, and pseudarthrosis. However, consequent to the study designs and clinical heterogeneity of the studies, it is not possible to correlate these complications accurately with any specific graft material employed. Further well-designed prospective studies are needed to correctly know the related morbidity of each graft used for achieving fusion in ACDF.

PMID:38421333 | DOI:10.1177/21925682231157320

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Complications With Demineralized Bone Matrix, Hydroxyapatite and Beta-Tricalcium Phosphate in Single and Two-Level Anterior Cervical Discectomy and Fusion Surgery

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Global Spine J. 2024 Feb;14(2_suppl):78S-85S. doi: 10.1177/21925682231157320.ABSTRACTSTUDY DESIGN: Systematic literature review.OBJECTIVES: To analyze the evidence available reporting complications in single or two-level anterior cervical discectomy and fusion (ACDF) using a demineralized bone matrix (DBM), hydroxyapatite (HA), or beta-tricalcium phosphate (β-TCP).METHODS: A systematic review of the literature using PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases was

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