117 - Transformainal Lumbar Interbody Fusion Rates with Actifuse®, i-FACTOR™...

#117 Transformainal Lumbar Interbody Fusion Rates with Actifuse®, i-FACTOR™ and Vitoss® BA Synthetic Bone Grafts

Biologic Therapies

Poster Presented by: A.J. Berg

Author(s):

A.J. Berg (1)
J.A. Tankel (1)
C.D. Jensen (1)
M. Hernandez (1)
C. Bhatia (1)
G.R. Reddy (1)
T. Friesem (1)

(1) North Tees and Hartlepool NHS Foundation Trust, Spinal Unit, Stockton on Tees, United Kingdom

Abstract

Introduction and Purpose: The gold standard bone graft for augmenting fusion is iliac crest autograft. Significant donor morbidity is associated with its harvest. Allografts require processing, to prevent transmission of infections, which impairs their osteogenic and osteoinductive properties. An alternative synthetic bone graft that avoids the morbidity of autograft, is safe and provides reliable fusion is therefore desired. In our institution we have used three synthetic bone grafts, Actifuse® (Baxter. USA), i-FACTOR™ (Cerapedics.USA) and Vitoss® BA (Stryker. USA), which all report to be bioactive and to enhance bone fusion in transforaminal lumbar interbody fusion (TLIF) procedures. They were all used in combination with morselized local autograft.

Methods: Patients undergoing TLIF surgery with one of the mentioned bone grafts were identified from hospital records. Postoperative radiographs were reviewed by an independent blinded radiologist for evidence of spanning trabeculae on orthogonal radiographs.

Results: 40 patients (55 levels) included. The number of patients, operated levels, follow-up and overall fusion rates for each bone graft group are demonstrated in Table 1. Cumulative fusion rates for each bone graft are shown in Table 2.

Conclusions: Patients who underwent TLIF with a mixture of i-FACTOR™ combined morselized local autograft had a higher rate of fusion with a similar mean follow-up and higher cumulative fusion rates over the period studied than Actifuse® and Vitoss® BA. The smaller patient numbers in the Actifuse® and Vitoss® BA groups does limit comparisons.

Table 1: Number of patients, levels, follow up.

Table 2: Cumulative fusion rate.