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Pseudarthrosis in Multilevel Anterior Cervical Fusion With rhBMP-2 and Allograft Analysis of One Hundred Twenty-Seven Cases With Minimum Two-Year Follow-up
DC Field | Value | Language |
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dc.contributor.author | Shen, Hong Xing | - |
dc.contributor.author | Buchowski, Jacob M. | - |
dc.contributor.author | Yeom, Jin S. | - |
dc.contributor.author | Liu, Gabriel | - |
dc.contributor.author | Lin, Nan | - |
dc.contributor.author | Riew, K. Daniel | - |
dc.creator | 염진섭 | - |
dc.date.accessioned | 2013-04-02T02:15:32Z | - |
dc.date.available | 2013-04-02T02:15:32Z | - |
dc.date.issued | 2010-04 | - |
dc.identifier.citation | SPINE Vol.35 No.7, pp. 747-753 | - |
dc.identifier.issn | 0362-2436 | - |
dc.identifier.uri | https://hdl.handle.net/10371/81641 | - |
dc.description.abstract | Study Design. Consecutive case series.Objective. The purpose of this study was to analyze the pseudarthrosis rate in a large series of recombinant human bone morphogenetic protein-2 (rhBMP-2) augmented multilevel (>= 3 levels) anterior cervical fusions.Summary of Background Data. The reported pseudarthrosis rate following anterior cervical fusion varies from 0% to 20% for single-level and up to 50% for multilevel fusions. It has been postulated that the use of rhBMP-2 may decrease the pseudarthrosis rate.Methods. A consecutive series of patients with cervical spondylosis and/or disc herniation who underwent anterior cervical fusion with rhBMP-2, structural allograft, and plate fixation with a minimum 2-year follow-up were analyzed by experienced, independent spine surgeons.Results. A total of 127 patients (54 men and 73 women with mean age of 54 +/- 10 years [range, 32-79]) were examined. Seventy-five (59.1%) patients underwent a 3-level fusion, 34 (26.7%) underwent a 4-level fusion, and 18 (14.2%) underwent a 5-level fusion. Of the 451 fusion segments, 14 segments (3.1%) in 13 of 127 patients (10.2%) had evidence of pseudarthrosis at 6 months following surgery. Of the 13 patients with a pseudarthrosis, 3 had a 3-level fusion (3/75 patients [4.0%]), 6 had a 4-level fusion (6/34 patients [17.4%]), and 4 had a 5-level fusion (4/18 patients [22.2%]). Five patients were asymptomatic and were not revised, but the remaining 8 patients required additional surgery. In 12 of 13 patients with a pseudarthrosis, the nonunion occurred at the lowest fusion level and at the cervicothoracic junction. The only statistically significant risk factor for developing a pseudarthrosis was the number of fusion levels.Conclusion. In a large series of rhBMP-2 augmented multilevel fusions, the pseudarthrosis rate was 10.2% at 6 months following surgery. Since the risk of pseudarthrosis increases with the number of fusion levels, a long fusion lever arm may biomechanically overwhelm the biologic advantage of rhBMP-2. While rhBMP-2 is known to enhance fusion rates, it does not guarantee fusion in all situations. | en |
dc.language.iso | en | en |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | en |
dc.subject | 의약학 | en |
dc.subject | anterior cervical fusion | - |
dc.subject | pseudarthrosis | - |
dc.subject | bone morphogenetic protein | - |
dc.subject | rhBMP-2 | - |
dc.title | Pseudarthrosis in Multilevel Anterior Cervical Fusion With rhBMP-2 and Allograft Analysis of One Hundred Twenty-Seven Cases With Minimum Two-Year Follow-up | en |
dc.type | Article | en |
dc.contributor.AlternativeAuthor | 염진섭 | - |
dc.description.srnd | OAIID:oai:osos.snu.ac.kr:snu2010-01/102/0000004226/1 | - |
dc.description.srnd | SEQ:1 | - |
dc.description.srnd | PERF_CD:SNU2010-01 | - |
dc.description.srnd | EVAL_ITEM_CD:102 | - |
dc.description.srnd | USER_ID:0000004226 | - |
dc.description.srnd | ADJUST_YN:Y | - |
dc.description.srnd | EMP_ID:A076317 | - |
dc.description.srnd | DEPT_CD:801 | - |
dc.description.srnd | CITE_RATE:2.51 | - |
dc.description.srnd | FILENAME:E025T_Spine-2009_Shen_Pseudarthrosis in multilevel anterior cervical fusion.pdf | - |
dc.description.srnd | DEPT_NM:의학과 | - |
dc.description.srnd | EMAIL:highcervical@gmail.com | - |
dc.description.srnd | SCOPUS_YN:Y | - |
dc.description.srnd | CONFIRM:Y | - |
dc.description.srnd | CONFIRM:Y | - |
dc.identifier.srnd | 2010-01/102/0000004226/1 | - |
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