Asian Spine J.  2017 Jun;11(3):454-462. 10.4184/asj.2017.11.3.454.

Use of Allogenic Mesenchymal Cellular Bone Matrix in Anterior and Posterior Cervical Spinal Fusion: A Case Series of 21 Patients

• Divi SN
• Mikhael MM

• KMID: 2382564
• DOI: http://doi.org/10.4184/asj.2017.11.3.454

Abstract

STUDY DESIGN: Retrospective case series. PURPOSE: To report our early experience using allogenic mesenchymal cellular bone matrix (CBM) products in cervical spine fusion. OVERVIEW OF LITERATURE: Multi-level cervical fusions have historically yielded lower fusion rates than single level fusions, especially in patients with high risk medical comorbidities. At this time, significant literature in cervical fusion outcomes with this cellular allograft technology is lacking.
METHODS
Twenty-one patients underwent either multilevel (3 or 4 level) anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, or posterior cervical fusion. ViviGen (DePuy Synthes Spine, Raynham, MA, USA), an allogenic bone matrix product, was used in addition to standard instrumentation. Radiographic evaluation was performed at 2 weeks, 12 weeks, 24 weeks and 1 year postoperative. Visual analog scale (VAS) and neck disability index (NDI) scores along with return to work and leisure activity were recorded.
RESULTS
At 6 months postoperative, all patients had radiographic evidence of bone fusion regardless of age or medical comorbidities. All patients reported subjective improvement with a mean decrease in VAS from 8.3 to 1.5 and a mean decrease in NDI from 40.3% to 6.0% at 1 year. All patients also returned to work and/or regular leisure activity within 3 months.
CONCLUSIONS
Twenty-one patients undergoing high-risk anterior and posterior cervical spine fusion, with the use of a commercially available mesenchymal CBM product, went on to radiographic fusion and all had improvement in subjective outcomes. While further effort and research is needed to validate its widespread use, this study shows favorable use of CBM in cervical fusion for high-risk cases.

Keyword

Bone matrix; Bone substitute; Allograft; Spinal fusion; Cervical vertebrae

MeSH Terms

Allografts
Bone Matrix*
Bone Substitutes
Cervical Vertebrae
Comorbidity
Diskectomy
Female
Humans
Leisure Activities
Neck
Retrospective Studies
Return to Work
Spinal Fusion*
Spine
Visual Analog Scale
Bone Substitutes