Literature DB >> 30834972

Evaluation of an increased strut porosity silicate-substituted calcium phosphate, SiCaP EP, as a synthetic bone graft substitute in spinal fusion surgery: a prospective, open-label study.

Ciaran Bolger1, Drew Jones2,3, Steven Czop3.   

Abstract

PURPOSE: Silicate-substituted calcium phosphate-enhanced porosity (SiCaP EP, Inductigraft™, Altapore) is a synthetic bone graft material with enhanced strut porosity of 31-47%. SiCaP EP remains to be fully clinically evaluated in patients undergoing instrumented posterolateral fusion (PLF) surgery. We conducted a prospective, open-label, non-randomised, multicentre clinical study to evaluate efficacy of SiCaP EP as bone grafting material in PLF surgery with instrumentation for treatment of spinal disorders.
METHODS: Patients with degenerative disc disease, spondylolisthesis or spinal stenosis underwent PLF surgery with SiCaP EP. The primary endpoint was evaluated in the per protocol population (N = 102) as solid fusion at postoperative month 12 assessed using computed tomography scans, with motion assessed using flexion-extension radiographs. Clinical outcomes included the Oswestry Disability Index, 36-item short-form health survey for quality-of-life, visual analog scale for pain scores and neurological assessments. Adverse events were recorded.
RESULTS: Successful fusion was achieved in 59/89 (66.3%) patients at month 6, 88/102 patients (86.3%) at month 12 (primary endpoint) and 87/96 (90.6%) patients at month 24. Disability and pain reduced following surgery. Quality-of-life improved and neurological function was maintained postoperatively. Forty-three (33.3%) of the 129 patients who underwent surgery experienced adverse events; back pain was most frequent (n = 10); nine and 14 patients experienced serious adverse events judged related to device and procedure, respectively.
CONCLUSIONS: Enhanced strut porosity SiCaP EP provided high (month 12: 86.3%) spinal fusion success rates in PLF surgery. Fusion success was associated with improved clinical outcomes in patients within 12 months, relative to baseline. CLINICALTRIALS. GOV IDENTIFIER: NCT01452022 These slides can be retrieved under Electronic Supplementary Material.

Entities:  

Keywords:  Degenerative disc disease; Porosity; Posterolateral fusion; Silicate-substituted calcium phosphate; Spinal fusion

Year:  2019        PMID: 30834972     DOI: 10.1007/s00586-019-05926-1

Source DB:  PubMed          Journal:  Eur Spine J        ISSN: 0940-6719            Impact factor:   3.134


  35 in total

Review 1.  The use of allograft bone in lumbar spine surgery.

Authors:  D M Ehrler; A R Vaccaro
Journal:  Clin Orthop Relat Res       Date:  2000-02       Impact factor: 4.176

Review 2.  Bone grafting alternatives in spinal surgery.

Authors:  Alexander R Vaccaro; Kazuhiro Chiba; John G Heller; Tushar Ch Patel; John S Thalgott; Eeric Truumees; Jeffrey S Fischgrund; Matthew R Craig; Scott C Berta; Jeffrey C Wang
Journal:  Spine J       Date:  2002 May-Jun       Impact factor: 4.166

3.  Efficacy of silicate-substituted calcium phosphate ceramic in posterolateral instrumented lumbar fusion.

Authors:  Louis G Jenis; Robert J Banco
Journal:  Spine (Phila Pa 1976)       Date:  2010-09-15       Impact factor: 3.468

4.  Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis.

Authors:  H N Herkowitz; L T Kurz
Journal:  J Bone Joint Surg Am       Date:  1991-07       Impact factor: 5.284

5.  Spinal fusion in the United States: analysis of trends from 1998 to 2008.

Authors:  Sean S Rajaee; Hyun W Bae; Linda E A Kanim; Rick B Delamarter
Journal:  Spine (Phila Pa 1976)       Date:  2012-01-01       Impact factor: 3.468

6.  Initial fusion rates with recombinant human bone morphogenetic protein-2/compression resistant matrix and a hydroxyapatite and tricalcium phosphate/collagen carrier in posterolateral spinal fusion.

Authors:  Steven D Glassman; John R Dimar; Leah Y Carreon; Mitchell J Campbell; Rolando M Puno; John R Johnson
Journal:  Spine (Phila Pa 1976)       Date:  2005-08-01       Impact factor: 3.468

7.  Smoking as a predictor of negative outcome in lumbar spinal fusion.

Authors:  T Andersen; F B Christensen; M Laursen; K Høy; E S Hansen; C Bünger
Journal:  Spine (Phila Pa 1976)       Date:  2001-12-01       Impact factor: 3.468

8.  Predictors of outcome after decompressive lumbar surgery and instrumented posterolateral fusion.

Authors:  Javier Cobo Soriano; Marcos Sendino Revuelta; Martín Fabregate Fuente; Ignacio Cimarra Díaz; Paloma Martínez Ureña; Roberto Deglané Meneses
Journal:  Eur Spine J       Date:  2010-02-05       Impact factor: 3.134

9.  Recombinant human bone morphogenetic protein-2 on an absorbable collagen sponge with an osteoconductive bulking agent in posterolateral arthrodesis with instrumentation. A prospective randomized trial.

Authors:  Edgar Dawson; Hyun W Bae; J Kenneth Burkus; Jeffery L Stambough; Steven D Glassman
Journal:  J Bone Joint Surg Am       Date:  2009-07       Impact factor: 5.284

10.  Effectiveness of physical therapy and epidural steroid injections in lumbar spinal stenosis.

Authors:  Zarife Koc; Suheda Ozcakir; Koncuy Sivrioglu; Alp Gurbet; Selcuk Kucukoglu
Journal:  Spine (Phila Pa 1976)       Date:  2009-05-01       Impact factor: 3.468

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