Abstract
Study Design: This is a retrospective study evaluating the use of BoneSave (Stryker, UK) in posterolateral inter-transverse spinal fusion.
Objectives. To evaluate the clinical outcomes and fusion success rates associated with the use of BoneSave in posterolateral spinal fusion.
Summary of Background Data: Achieving spinal fusion is the guiding principle behind surgical treatment for a range of pathologies of the spine. The use of a substantial amount of bonegraft is often required and autograft, commonly harvested from the iliac crest, represents the gold standard. Morbidities associated with graft harvest and a limited supply of graft material have led to the development of alternatives. BoneSave, a porous tricalcium phosphate-hydroxyapatite ceramic, is one such alternative which has been employed in spinal fusion over the past few years. Despite this the outcomes associated with its use lack research.
Methods: Clinical data was collected retrospectively from the case notes of all patients who underwent posterolateral inter-transverse spinal fusion at any level, involving the application of BoneSave, between June 2003 and January 2005 at Frenchay hospital, Bristol, UK. A postal questionnaire was used to collect the latest follow-up information, with an average follow-up of 46 months. Validated outcome instruments employed included the Short Form 36 and Oswestry Low Back Pain Disability Index. In addition visual analogue scales for both back and leg pain, Patient Global Impression of Change data, work status, persisting symptoms, and patient satisfaction data was collected. Radiological evaluation of fusion was carried out from the most recent spinal radiographs available for each patient.
Results: There were 45 patients in the study group. Qualitative post-operative data was available in 96% and response rate to the follow-up questionnaire was 68.4%. Radiographical evaluation was possible in 67%. Significant post-operative improvements were seen across all outcome measures in the large majority of cases. Successful fusion was achieved in 56.7% of cases.
Conclusion: The clinical outcomes associated with the use of BoneSave are comparable to those available in the literature for more conventional techniques of spinal fusion. The fusion rate was not significantly lower than achieved with other techniques.
The abstracts were prepared by Mr D J Bracey, Editorial Secretary. Correspondence should be addressed to him at Royal Cornwall Hospital, Treliske, Cornwall TR1 3LJ, England.
