[Comparison of anterior lumbar fusion rates after circumferential fusion using beta-tricalcium phosphate (Cerasorb) versus autologous iliac crest spongiosa].
OBJECTIVE
The aim of this prospective clinical trial was to analyse the ventral fusion rate following circumferential fusion for degenerative spine disease using a radiolucent carbon fibre cage (Brantigan, Fa. DePuy-Acromed) loaded with either autogeneous bone graft (iliac crest) or with the tricalcium phosphate Cerasorb with PRP (Curasan AG, Kleinostheim, Deutschland).


METHODS
In 26 patients (15 female, 11 male, average age: 57.7 years) a circumferential fusion of the lumbar spine was performed (titanium posterior instrumentation and Brantigan, Fa. DePuy-Acromed). Autogeneous bone graft (iliac crest) and Cerasorb-PRP as cage filling substance were randomly assigned to each level in all patients. Anterior fusion was evaluated in a total number of 69 Brantigan cages by radiographs after 3, 6, 9 and 12 months and by CT 1 year after surgery.


RESULTS
The evaluation of radiographs resulted in a fusion rate 49 %. This was significantly different from the fusion rate accessed by CT scanning (28 %). None of the Brantigan cages (n = 33) filled with Cerasorb with PRP showed an anterior fusion in the CT while fusion was proven in 19 of 36 (49 %) Brantigan cages loaded with cancellous bone from the iliac crest.


CONCLUSIONS
The use a of cancellous bone from the iliac crest as filling substance for Brantigan cages in circumferential fusion of the lumbar spine leads to a significantly higher anterior fusion rate than Cerasorb with PRP.
Hagel
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Universitätsklinik und Poliklinik für Orthopädie und Physikalische Medizin, Martin-Luther-Universität, Halle-Wittenberg. alexander.hagel@medizin.uni-halle.de
Zeh
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Hein
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Held
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Wohlrab
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D001860:Bone Plates; D018786:Bone Substitutes / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome
D018786:Bone Substitutes; D002130:Calcium Phosphates; C485817:beta-tricalcium phosphate