The results of beta-tricalcium phosphate coated hydroxyapatite (beta-TCP/HA) grafts for interbody fusion after anterior cervical discectomy

J Spinal Disord Tech. 2008 Aug;21(6):436-41. doi: 10.1097/BSD.0b013e318157d365.

Abstract

Study design: The efficacy of tricalcium phosphate and hydroxyapatite (beta-TCP/HA) grafts was studied after anterior cervical discectomy (ACD).

Objective: This study presents our observations about the efficacy of beta-TCP/HA grafts after ACD.

Summary of background data: Especially in the last 2 decades, fusion materials such as autograft and allograft, as well as different kind of cages were used to maintain fusion after ACD.

Methods: beta-TCP/HA grafts after ACD were used in 17 patients. The cervical and radicular pain was evaluated via visual analog scale (VAS) score preoperatively, at postoperative third week, and after 20 months (range: 18 to 24 mo) after the operation. The radiologic evaluations were done preoperatively, at postoperative first day and at the latest follow-up. The VAS, intervertebral space ratio, height of intervertebral disc space and neural foramen, and cervical and segmental lordosis angles were recorded preoperatively and during the postoperative follow-up period. The presence of fusion was controlled in computed tomography scans taken at the latest follow-up.

Results: Both clinical and radiologic evaluations yielded satisfactory results. VAS scores decreased significantly in all patients. The intervertebral space and neural foramen and intervertebral disc heights increased at postoperative day 1 but were found to be decreased at the latest follow-up (P<0.05). On the contrary the cervical and segmental lordosis angles decreased at postoperative day 1 but were found to be increased at the latest follow-up (P<0.05). There was a solid fusion in 16 out of 17 patients (94.11%).

Conclusions: Although there was a loss of the initially obtained neural foraminal and disc height, the application of beta-TCP/HA graft after ACD resulted in a high rate of fusion and patient satisfaction. Additionally, the cervical and segmental lordosis was preserved. We concluded that it is a good alternative to current methods to maintain cervical alignment and fusion after ACD.

MeSH terms

  • Adult
  • Biocompatible Materials / therapeutic use*
  • Calcium Phosphates / therapeutic use*
  • Cervical Vertebrae / surgery
  • Diskectomy
  • Durapatite / therapeutic use*
  • Female
  • Humans
  • Intervertebral Disc
  • Male
  • Middle Aged
  • Prostheses and Implants
  • Spinal Fusion / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Biocompatible Materials
  • Calcium Phosphates
  • beta-tricalcium phosphate
  • Durapatite