title: Postoperative lumbar spinal stenosis after intertransverse fusion with granules of hydroxyapatite: a case report.
abstract: In the present case of postoperative lumbar spinal stenosis after non-instrumented intertransverse fusion with granules of hydroxyapatite (HA), bone union was not completed and the patient felt the recurrence of his symptoms within two years. We performed re-decompression with fusion, and in hematoxylin and eosin staining of HA granulation harvested during revision surgery, fibrous tissue with hyaline degeneration surrounded the cavity where the HA had existed. Multinuclear giant cells and lymphocytes infiltrated some parts of the marginal layer of the cavity, and no obvious bony bridge had regenerated from autologous bone. No tartrate-resistant acid phosphate (TRAP) -positive osteoclasts could be seen in the new bone, suggesting that the activity of osteoclasts in the new bone decreased during the seven years after the primary surgery.
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authors.affiliation: Department of Orthopaedic Surgery, Kitasato University, School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan. ginoue@kitasato-u.ac.jp
authors.forename: Gen
authors.initials: G
authors.lastname: Inoue
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ozawa
authors.forename: Toshinori
authors.initials: T
authors.lastname: Ito
authors.forename: Morihiro
authors.initials: M
authors.lastname: Higashi
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.forename: Junichi
authors.initials: J
authors.lastname: Nakamura
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Toyone
authors.forename: Masashi
authors.initials: M
authors.lastname: Takaso
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D019299:Decompression, Surgical; D017886:Durapatite / Q000009:adverse effects*; D015726:Giant Cells / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D010010:Osteoclasts / Q000473:pathology; D012008:Recurrence; D012086:Reoperation; D013123:Spinal Fusion / Q000009:adverse effects*; D013130:Spinal Stenosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013194:Staining and Labeling; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure
chemical_list: D017886:Durapatite