Cage containing a biphasic calcium phosphate ceramic (Triosite) for the treatment of cervical spondylosis.

Abstract

BACKGROUND:

We evaluated the fusion efficacy and clinical outcomes of a cage containing a biphasic calcium phosphate ceramic (Triosite) in treating cervical spondylosis.

METHODS:

We randomly divided 100 patients with cervical spondylosis undergoing anterior discectomy with interbody polyetheretherketone (PEEK) fusion into 2 groups in the past 2 years: group A (n = 50), PEEK cage containing a biphasic calcium phosphate ceramic (Triosite), and group B (n = 50), PEEK cage containing an autogenous iliac bone graft. We compared the fusion rate, fusion time, spinal curvature, and neuroforamen size between the 2 groups. We also compared excess operation time, excess blood loss, hospital stay, complications, and neurological recovery status between the groups.

RESULTS:

The fusion rates were 57%, 67%, 77%, 82%, 92%, and 100% in group A and 81%, 86%, 95%, 95% 100%, and 100% in group B in the first 6 postoperative months. The fusion rate in group A was significantly lower than that in group B in the first 5 months after the procedure (P < .05 and P < .01, respectively), but the fusion rate reached 100% in both groups by the sixth month. Within the first 6 months, as the fusion level increased, the fusion rates reduced and time to fusion was delayed in both groups. There were no donor site complications in group A. However, 3 patients (6%) from group B experienced complications (1, wound infection; 1, numbness of thigh; and 1, subcutaneous hematoma) (P < .001). The hospital stay was shorter in group A (4.43 +/- 2.36 days) than in group B (7.00 +/- 3.77 days) (P = .001). The mean excessive blood loss and excessive operative time for an iliac bone graft in group B were 15 +/- 5 mL and 10 +/- 6 minutes. There was no statistical significance in spinal curve correction, neuroforamen enlargement, and neurological recovery.

CONCLUSIONS:

A cage containing a biphasic calcium phosphate ceramic resulted in complete fusion by the sixth postoperative month, although the fusion rate was lower than that in a cage containing an autograft during the first 5 months after the operation and the time to fusion was delayed. Using a cage containing a biphasic calcium phosphate ceramic leads to a shorter hospital stay, less blood loss, shorter operative time, and no donor site complications. It seemed to be a good substitute for cervical spondylotic fusion.

• Authors: Der-Yang Cho, Wuen-Yen Lee, Pon-Chun Sheu, Chun-Chung Chen
• Journal: Surgical neurology (Surg Neurol) Vol. 63 Issue 6 Pg. 497-503; discussion 503-4 (Jun 2005) ISSN: 0090-3019 [Print] United States
• PMID: 15936361 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Calcium Phosphates
• Hydroxyapatites
• hydroxyapatite-tricalciumphosphate composite

Topics

• Absorbable Implants
• Bone Transplantation (adverse effects, methods, statistics & numerical data)
• Calcium Phosphates (therapeutic use)
• Cervical Vertebrae (pathology, physiopathology, surgery)
• Diskectomy (instrumentation, methods)
• Female
• Humans
• Hydroxyapatites (therapeutic use)
• Ilium (transplantation)
• Length of Stay
• Male
• Middle Aged
• Postoperative Complications (etiology, pathology, physiopathology)
• Postoperative Hemorrhage (prevention & control)
• Spinal Fusion (instrumentation, methods)
• Spinal Osteophytosis (pathology, physiopathology, surgery)
• Time Factors
• Treatment Outcome