Impact of Surgical Risk Factors for Non-union on Lumbar Spinal Fusion Outcomes Using Cellular Bone Allograft at 24-months Follow-up

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2024 May 3

PMID 38702654

Authors

Anthony Russo

Daniel K Park

Todd Lansford

Pierce Nunley

Timothy A Peppers

Joshua J Wind

Hamid Hassanzadeh

Joseph Sembrano

Jung Yoo

Jonathan Sales

Affiliations

Soon will be listed here.

Abstract

Background: The current report investigates fusion rates and patient-reported outcomes following lumbar spinal surgery using cellular bone allograft (CBA) in patients with risk factors for non-union.

Methods: A prospective, open label study was conducted in subjects undergoing lumbar spinal fusion with CBA (NCT02969616) to assess fusion success rates and patient-reported outcomes in subjects with risk factors for non-union. Subjects were categorized into low-risk (≤ 1 risk factors) and high-risk (> 1 risk factors) groups. Radiographic fusion status was evaluated by an independent review of dynamic radiographs and CT scans. Patient-reported outcome measures included quality of life (EQ-5D), Oswestry Disability Index (ODI) and Visual Analog Scales (VAS) for back and leg pain. Adverse event reporting was conducted throughout 24-months of follow-up.

Results: A total of 274 subjects were enrolled: 140 subjects (51.1%) were categorized into the high-risk group (> 1 risk factor) and 134 subjects (48.9%) into the low-risk group (≤ 1 risk factors). The overall mean age at screening was 58.8 years (SD 12.5) with a higher distribution of females (63.1%) than males (36.9%). No statistical difference in fusion rates were observed between the low-risk (90.0%) and high-risk (93.9%) groups (p > 0.05). A statistically significant improvement in patient-reported outcomes (EQ-5D, ODI and VAS) was observed at all time points (p < 0.05) in both low and high-risk groups. The low-risk group showed enhanced improvement at multiple timepoints in EQ-5D, ODI, VAS-Back pain and VAS-Leg pain scores compared to the high-risk group (p < 0.05). The number of AEs were similar among risk groups.

Conclusions: This study demonstrates high fusion rates following lumbar spinal surgery using CBA, regardless of associated risk factors. Patient reported outcomes and fusion rates were not adversely affected by risk factor profiles.

Trial Registration: NCT02969616 (21/11/2016).

Citing Articles

Risk factors and treatment strategies for adjacent segment disease following spinal fusion (Review).

Huang X, Cai Y, Chen K, Ren Q, Huang B, Wan G Mol Med Rep. 2024; 31(2).

PMID: 39575466 PMC: 11605282. DOI: 10.3892/mmr.2024.13398.

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