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2 results on '"AO Spine Knowledge Forum Degenerative"'

1. Autologous Stem Cells in Cervical Spine Fusion

Author

Patrick C. Hsieh, Andrea C. Skelly, Jong-Beom Park, Darrel S. Brodke, Jeffrey C. Wang, Erika D. Brodt, Ki Chang, Zorica Buser, Andrew S. Chung, Hans Joerg Meisel, AO Spine Knowledge Forum Degenerative, and S Timothy Yoon

Subjects
fusion, allograft, Pathology, medicine.medical_specialty, bone marrow aspirate, autograft, business.industry, Cervical spine fusion, Adipose tissue, autologous, Bone marrow aspirate, cervical fusion, medicine, Orthopedics and Sports Medicine, Surgery, Neurology (clinical), Cervical fusion, Stem cell, business, Review Articles
Abstract

Study Design: Systematic review. Objectives: To systematically review, critically appraise and synthesize evidence on use of stem cells from autologous stem cells from bone marrow aspirate, adipose, or any other autologous sources for fusion in the cervical spine compared with other graft materials. Methods: A systematic search of PubMed/MEDLINE was conducted for literature published through October 31, 2018 and through February 20, 2020 for EMBASE and ClinicalTrials.gov comparing autologous cell sources for cervical spine fusion to other graft options. Results: From 36 potentially relevant citations identified, 10 studies on cervical fusion met the inclusion criteria set a priori. Two retrospective cohort studies, one comparing cancellous bone marrow (CBM) versus hydroxyapatite (HA) and the other bone marrow aspirate (BMA) combined with autograft and HA versus autograft and HA alone, were identified. No statistical differences were seen between groups in either study for improvement in function, symptoms, or fusion; however, in the study evaluating BMA, the authors reported a statistically greater fusion rate and probability of fusion over time in the BMA versus the non-BMA group. Across case series evaluating BMA, authors reported improved function and pain and fusion ranged from 84% to 100% across the studies. In general, complications were poorly reported. Conclusions: The overall quality (strength) of evidence of effectiveness and safety of autologous BMA for cervical arthrodesis in the current available literature was very low. Based on currently available data, firm conclusions regarding the effectiveness or safety of BMA in cervical fusions cannot be made.

Published
2020

2. Demographic, clinical, and operative risk factors associated with postoperative adjacent segment disease in patients undergoing lumbar spine fusions: a systematic review and meta-analysis.

Author

Mesregah, Mohamed Kamal, Yoshida, Brandon, Lashkari, Nassim, Abedi, Aidin, Meisel, Hans-Joerg, Diwan, Ashish, Hsieh, Patrick, Wang, Jeffrey C., Buser, Zorica, Yoon, S. Tim, and AO Spine Knowledge Forum Degenerative

Subjects
*PREOPERATIVE risk factors, *SPINAL fusion, *SPINAL surgery, *LUMBAR vertebrae, *ZYGAPOPHYSEAL joint, *BODY mass index, *ODDS ratio
Abstract

Background Context: Adjacent segment disease (ASD) is a potential complication following lumbar spinal fusion.Purpose: This study aimed to demonstrate the demographic, clinical, and operative risk factors associated with ASD development following lumbar fusion.Study Design/setting: Systematic review and meta-analysis.Patient Sample: We identified 35 studies that reported risk factors for ASD, with a total number of 7,374 patients who had lumbar spine fusion.Outcome Measures: We investigated the demographic, clinical, and operative risk factors for ASD after lumbar fusion.Methods: A literature search was done using PubMed, Embase, Medline, Scopus, and the Cochrane library databases from inception to December 2019. The methodological index for non-randomized studies (MINORS) criteria was used to assess the methodological quality of the included studies. A meta-analysis was done to calculate the odds ratio (OR) with the 95% confidence interval (CI) for dichotomous data and mean difference (MD) with 95% CI for continuous data.Results: Thirty-five studies were included in the qualitative analysis, and 22 studies were included in the meta-analyses. The mean quality score based on the MINORS criteria was 12.4±1.9 (range, 8-16) points. Significant risk factors included higher preoperative body mass index (BMI) (mean difference [MD]=1.97 kg/m2; 95% confidence interval [CI]=1.49-2.45; p<.001), floating fusion (Odds ratio [OR]=1.78; 95% CI=1.32-2.41; p<.001), superior facet joint violation (OR=10.43; 95% CI=6.4-17.01; p<.001), and decompression outside fusion construct (OR=1.72; 95% CI=1.25-2.37; p<.001).Conclusions: The overall level of evidence was low to very low. Higher preoperative BMI, floating fusion, superior facet joint violation, and decompression outside fusion construct are significant risk factors of development of ASD following lumbar fusion surgeries. [ABSTRACT FROM AUTHOR]

Published
2022
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