{"title":"Hydroxyapatite/collagen composite graft for anterior cervical discectomy and fusion: a comparison with Iliac crest bone graft.","authors":"Yu Matsukura, Takashi Hirai, Motonori Hashimoto, Kentaro Sakaeda, Kenichiro Sakai, Ichiro Torigoe, Kentaro Yamada, Masaki Tomori, Kyohei Sakaki, Shingo Morishita, Satoru Egawa, Hiroaki Onuma, Jun Hashimoto, Kurando Utagawa, Takuya Takahashi, Yoshiyasu Arai, Toshitaka Yoshii","doi":"10.1186/s12891-025-08782-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The iliac crest bone graft (ICBG) has been traditionally used as the gold standard for anterior cervical discectomy and fusion (ACDF). However, the complication rate associated with harvesting the tricortical ICBG is significantly high. Thus, this study aimed to investigate the efficacy of the hydroxyapatite/collagen (HAp/Col) composite graft combined with an intervertebral cage in ACDF.</p><p><strong>Methods: </strong>This was a retrospective study investigated 49 consecutive patients who underwent one- or two-level ACDF using the HAp/Col composite graft combined with an intervertebral cage at two institutions from March 2016 to January 2019. Clinical and radiological evaluations were performed before the surgeries and during the postoperative follow-up. Further, the outcomes of ACDF using the HAp/Col composite graft combined with the cage were compared with those of the tricortical ICBG without the cage.</p><p><strong>Results: </strong>The Japanese Orthopaedic Association (JOA) scores of the HAp/Col and ICBG groups at 2 years postoperatively improved significantly compared with those preoperatively. The two groups did not significantly differ in terms of the recovery rate based on the JOA scores at 2 years postoperatively. The fusion rates in the HAp/Col group (one-level, 95.7%; two-level, 92.0%) were comparable to those in ICBG group (one-level, 100%; two-level, 88.9%) at 2 years postoperatively. The surgical time was significantly shorter in the HAp/Col group (one-level, 113.2 min; two-level, 157.5 min) than in the ICBG group (one-level, 161.0 min; 2-level, 223.3 min) for both one- and two-level fusions. Intraoperative blood loss was significantly lower in the HAp/Col group than in the ICBG group in two-level fusion (HAp/Col, 34.1 g; ICBG, 215.4 g).</p><p><strong>Conclusions: </strong>The HAp/Col composite graft with an intervertebral cage could be a safe and effective alternative scaffold to the conventional autologous iliac tricortical grafts in ACDF.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"552"},"PeriodicalIF":2.2000,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135594/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Musculoskeletal Disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12891-025-08782-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The iliac crest bone graft (ICBG) has been traditionally used as the gold standard for anterior cervical discectomy and fusion (ACDF). However, the complication rate associated with harvesting the tricortical ICBG is significantly high. Thus, this study aimed to investigate the efficacy of the hydroxyapatite/collagen (HAp/Col) composite graft combined with an intervertebral cage in ACDF.
Methods: This was a retrospective study investigated 49 consecutive patients who underwent one- or two-level ACDF using the HAp/Col composite graft combined with an intervertebral cage at two institutions from March 2016 to January 2019. Clinical and radiological evaluations were performed before the surgeries and during the postoperative follow-up. Further, the outcomes of ACDF using the HAp/Col composite graft combined with the cage were compared with those of the tricortical ICBG without the cage.
Results: The Japanese Orthopaedic Association (JOA) scores of the HAp/Col and ICBG groups at 2 years postoperatively improved significantly compared with those preoperatively. The two groups did not significantly differ in terms of the recovery rate based on the JOA scores at 2 years postoperatively. The fusion rates in the HAp/Col group (one-level, 95.7%; two-level, 92.0%) were comparable to those in ICBG group (one-level, 100%; two-level, 88.9%) at 2 years postoperatively. The surgical time was significantly shorter in the HAp/Col group (one-level, 113.2 min; two-level, 157.5 min) than in the ICBG group (one-level, 161.0 min; 2-level, 223.3 min) for both one- and two-level fusions. Intraoperative blood loss was significantly lower in the HAp/Col group than in the ICBG group in two-level fusion (HAp/Col, 34.1 g; ICBG, 215.4 g).
Conclusions: The HAp/Col composite graft with an intervertebral cage could be a safe and effective alternative scaffold to the conventional autologous iliac tricortical grafts in ACDF.
期刊介绍：
BMC Musculoskeletal Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of musculoskeletal disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
The scope of the Journal covers research into rheumatic diseases where the primary focus relates specifically to a component(s) of the musculoskeletal system.
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