Tavşanlarda Spinal Lomber Füzyon için Otogreft ve DBM Flex'in (Grafton) Deneysel Karşılaştırması

Abstract

Öz Amaç: Spinal füzyon için kullanılan greft materyallerinin seçimi, kemiğin yeniden şekillenmesindeki önemli rolleri nedeniyle büyük önem taşımaktadır. Otojen kemik greftleri spinal füzyon ameliyatlarında ‘‘altın standart’’ olarak bilinmektedir. Otojen kemik grefti yerine kullanılabilecek sentetik greft materyaller ile ilgili çalışmalar son yıllarda önem kazanmıştır. Bu çalışmanın amacı tavşan spinal lomber füzyon (SLF) modelinde, demineralize kemik matriksi ve otogreftin etkinliğini karşılaştırmaktır. Yöntem: Yirmi Yeni Zelanda tavşanı rastgele iki gruba ayrıldı ve iliak krest otolog kemik grefti (Autogreft, n=10) veya DBM Flex (Grafton, n=10) kullanılarak SLF uygulandı. Ameliyattan sekiz hafta sonra hayvanlar sakrifiye edildi ve spinal füzyon bilgisayarlı tomografi (BT), manuel palpasyon, makroskopik analizler ve histolojik değerlendirmelerle değerlendirildi. Bulgular: BT sonuçları, otogreftin DBM Flex'ten anlamlı derecede daha yüksek füzyon skorları sağladığını ortaya koydu (p=0,0004). Hareketlilik otogreft grubunda anlamlı olarak daha düşüktü (p=0,0007). DBM Flex grubunda, otogreft grubuna kıyasla anlamlı derecede daha düşük kemik oluşum skorları gözlendi (p<0,0001). Otogreft grubundaki omurga histolojisi, DBM Flex grubuna göre anlamlı olarak daha iyiydi (p=0,0002). Sonuç: Otogreft, SLF'de DBM flex'ten daha bulunmuştur ve bu sonuçlar da otogreftin gelecekte SLF'de “altın standart” olmasının muhtemel olduğunu göstermektedir.

Keywords

• Otogreft
• DBM Flex
• Demineralize kemik matrisi
• Grafton
• Spinal füzyon cerrahisi

Experimental Comparison of Autograft and DBM Flex (Grafton) for Spinal Lumbar Fusion in Rabbits

Abstract

Aim: The choice of graft materials used for spinal fusion possesses a great importance due to their crucial roles in bone remodelling. Autogenous bone grafts are known as the "gold standard" in spinal fusion surgeries. Studies on synthetic graft materials that can be used instead of autogenous bone grafts have gained importance in recent years. The aim of this study was to compare the efficacy of demineralized bone matrix and autograft in the rabbit spinal lumbar fusion (SLF) model. Methods: Twenty New Zealand rabbits were randomly divided into two groups and underwent SLF by using either iliac crest autologous bone graft (Autograft, n=10) or DBM Flex (Grafton, n=10). Eight-weeks after surgery, animals were sacrificed and spinal fusion was evaluated by computerized tomography (CT), manual palpation, macroscopic analyses, and histological assessments. Results: CT results revealed that autograft led to significantly higher fusion scores than DBM Flex (p=0.0004). Mobility was significantly lower in autograft group (p=0.0007). Significantly lower bone formation scores were observed in DBM Flex group compared to autograft group (p<0.0001). Histology of spine in the autograft group was significantly better than DBM Flex group (p=0.0002). Conclusion: Autograft was superior than DBM flex in SLF and autograft will likely to be the “gold standard” in SLF in the future.

Keywords

• Autograft
• DBM Flex
• Demineralized bone matrix
• Grafton
• Spinal fusion surgery

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