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Choi, Kim, Lee, and Lee: The Radiologic Result of Silicon-Containing Porous Hydroxyapatite Packed within a Cage in Posterior Lumbar Interbody Fusion of Lumbar Spine: Preliminary Study
Original Article

Journal of the Korean Orthopaedic Association 2015; 50(5): 401-406.

Published online: 23 October 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.5.401

The Radiologic Result of Silicon-Containing Porous Hydroxyapatite Packed within a Cage in Posterior Lumbar Interbody Fusion of Lumbar Spine: Preliminary Study

Seung-Myung Choi, M.D., Yong-Min Kim, M.D., Hyeong-Jun Lee, M.D., Jong-Hyuk Lee, M.D.

Department of Orthopaedic Surgery, Chungbuk National University College of Medicine, Cheongju, Korea.

Correspondence to: Yong-Min Kim, M.D. Department of Orthopaedic Surgery, Chungbuk National University Hospital, 776 1sunhwan-ro, Seowon-gu, Cheongju 28644, Korea. TEL: +82-43-269-6077, FAX: +82-43-274-8719, ymkim@chungbuk.ac.kr

Received 2 November 2014       Revised 24 March 2015       Accepted 7 May 2015

Copyright © 2015 by The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The objective of this study is to analyze the radiologic fusion rate in posterior lumbar interbody fusion (PLIF) using silicon-containing porous hydroxyapatite (Si-HA) chips packed within a cage.

Materials and Methods

Twelve patients who underwent PLIF using Si-HA (BoneMedik-S™; Meta-Biomed, Cheongju, Korea) blocks packed within a cage were enrolled. PLIF was performed in the same manner in all patients. A cage filled with Si-HA was inserted into disc space. Serial X-rays and 3-dimensional computed tomography (3D-CT) were performed for evaluation of the fusion status.

Results

At postoperative 12 months, 11 cases showed grade IV and one case showed grade III on X-rays. At postoperative 24 months, all cases showed grade IV (complete fusion). Assessment of fusion by 3D-CT also showed grade I in all cases at postoperative 12 months.

Conclusion

Considering the above results, Si-HA packed in a cage appears to be an effective bone graft material for use in PLIF.

Keywords: lumbar vertebrae, posterior lumbar interbody fusion, silicon-containing porous hydroxyapatite

Figures and Tables

Figure 1

Photos of cage and block shaped hydroxyapatite (BoneMedik-S™; Meta-Biomed, Cheongju, Korea).

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Figure 2

(A, B) Immediate postoperative radiograph shows interbody fusion with cage using a hydroxyapatite graft on the right (white arrows) and a strut autobone graft on the left (black arrow). (C, D) Postoperative radiograph (24 months later) shows complete bony fusion with trabeculation between L4 and L5 body on the right (white arrows) and comparable to autobone graft on the left (black arrow).

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Figure 3

Postoperative 3-dimensional computed tomography image (24 months later) in interbody fusion with a cage using hydroxyapatite graft on the right and strut autobone graft on the left shows complete bony fusion (A) with trabeculation on cage filled with hydroxyapatite only (B) as well as autobone graft side (C).

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Table 1

Classification of Fusion Results (Plain X-Ray)

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Data from the article of Park et al. (J Korean Neurosurg Soc 2011;49:267-72).9)

Table 2

Computed Tomography-Based Classification of Spinal Fusion

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Data from the article of Tan et al. (Eur Spine J 2007;16:1875-81).12)

Table 3

Comparison between Postoperative MIH and LSSA (Wilcoxon Signed Rank Test)*

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Values are presented as mean (range). *p>0.05. MIH, middle intervertebral height; LSSA, lateral segmental sagittal angle.

Notes

This work was supported by research grant of Chungbuk National University in 2014.

CONFLICTS OF INTEREST The authors have nothing to disclose.

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