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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

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dc.contributor.authorShen, Hong Xing-
dc.contributor.authorBuchowski, Jacob M.-
dc.contributor.authorYeom, Jin S.-
dc.contributor.authorLiu, Gabriel-
dc.contributor.authorLin, Nan-
dc.contributor.authorRiew, K. Daniel-
dc.creator염진섭-
dc.date.accessioned2013-04-02T02:15:32Z-
dc.date.available2013-04-02T02:15:32Z-
dc.date.issued2010-04-
dc.identifier.citationSPINE Vol.35 No.7, pp. 747-753-
dc.identifier.issn0362-2436-
dc.identifier.urihttps://hdl.handle.net/10371/81641-
dc.description.abstractStudy 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.isoenen
dc.publisherLIPPINCOTT WILLIAMS & WILKINSen
dc.subject의약학en
dc.subjectanterior cervical fusion-
dc.subjectpseudarthrosis-
dc.subjectbone morphogenetic protein-
dc.subjectrhBMP-2-
dc.titlePseudarthrosis in Multilevel Anterior Cervical Fusion With rhBMP-2 and Allograft Analysis of One Hundred Twenty-Seven Cases With Minimum Two-Year Follow-upen
dc.typeArticleen
dc.contributor.AlternativeAuthor염진섭-
dc.description.srndOAIID:oai:osos.snu.ac.kr:snu2010-01/102/0000004226/1-
dc.description.srndSEQ:1-
dc.description.srndPERF_CD:SNU2010-01-
dc.description.srndEVAL_ITEM_CD:102-
dc.description.srndUSER_ID:0000004226-
dc.description.srndADJUST_YN:Y-
dc.description.srndEMP_ID:A076317-
dc.description.srndDEPT_CD:801-
dc.description.srndCITE_RATE:2.51-
dc.description.srndFILENAME:E025T_Spine-2009_Shen_Pseudarthrosis in multilevel anterior cervical fusion.pdf-
dc.description.srndDEPT_NM:의학과-
dc.description.srndEMAIL:highcervical@gmail.com-
dc.description.srndSCOPUS_YN:Y-
dc.description.srndCONFIRM:Y-
dc.description.srndCONFIRM:Y-
dc.identifier.srnd2010-01/102/0000004226/1-
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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