Efficacy of Beta Tricalcium Phosphate and MacroPore Sheet in Anterior Iliac Crest Reconstruction

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Beta-tricalcium phosphate (B-TCP: Vitoss, Orthovita, Malverne, PA) is a newly developed non-weight bearing bone void filler. Blocks of B-TCP are osteoconductive. When combined with autogenous bone marrow aspirate, its substantial wicking capabilities, trap osteoblasts and nutrients, making it additionally osteoinductive and osteogenic.<br>Ten patients underwent single level anterior cervical corpectomy and fusion procedures (i.e. C5-C7) with dynamic ABC plates (Aesculap, Tuttlingen, Germany). Iliac crest autografts, averaging 1.2 cm in depth x 1.4 cm in width x 2.8 cm in length, were harvested, and defects were filled with blocks of B-TCP and MacroPore Sheet (San Diego, CA). 2D-CT scans at 3 and 6 months postoperatively documented progressive fusion characterized by increasing ossification and coalescence of B-TCP particles within the defect; Grade I (50%), Grade II (70%), and Grade III (100%). Outcomes were assessed utilizing a Visual Analog Pain Scale (1-10) and the SF-36 Bodily Pain Scale recorded 3 and 6 months postoperatively.<br>Postoperative 2D-CT studies of iliac crest reconstructions revealed Grade II (70%) partial fusion within 3 months, and Grade III (100%) complete fusion 6 months following surgery. One patient who developed a hematoma at the operative site demonstrated moderate myositis ossificans on the 2D-CT examination. On the Visual Analog Pain Scale patients demonstrated an average score of 5.2 at three months and 2.0 six months postoperatively. Bodily Pain Scores on the SF-36 showed average preoperative scores of 20, which improved to 35 at three months and 52 at six months postoperatively (higher numbers reflected better outcomes). Patients were followed a minimum of 6 months and average of 12 months postoperatively.<br>B-TCP proved effective as a bone void filler in iliac crest donor site reconstruction and may supplement autograft and supplant allograft for comparable types of fusions.

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  • 脊髄外科

    脊髄外科 19 (2), 103-109, 2005

    日本脊髄外科学会

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