PMID- 37254205
OWN - NLM
STAT- MEDLINE
DCOM- 20230601
LR  - 20230601
IS  - 1749-799X (Electronic)
IS  - 1749-799X (Linking)
VI  - 18
IP  - 1
DP  - 2023 May 30
TI  - First clinical experience with posterior lumbar interbody fusion using a 
      thermal-sprayed silver-containing hydroxyapatite-coated cage.
PG  - 392
LID - 10.1186/s13018-023-03882-7 [doi]
LID - 392
AB  - BACKGROUND: To investigate the possibility of silver (Ag)-induced adverse events 
      and the degree of bone fusion in posterior lumbar interbody fusion surgery using 
      an Ag-containing hydroxyapatite (HA) lumbar interbody cage. METHODS: An Ag-HA 
      cage consisting of highly osteoconductive HA interfused with Ag was developed, 
      and we applied it clinically at three university-affiliated hospitals from April 
      2020 to December 2020. During the 12-month postoperative observation period, 
      Ag-related adverse events, neuropathy, and postoperative complications were 
      investigated as indicators of safety, while clinical improvement and the fusion 
      status were investigated as indicators of efficacy. Clinical improvement was 
      defined as improvement beyond the minimum clinically important difference (MCID) 
      in the numerical rating scale (NRS; 1.6) for low back and lower limb pain and the 
      Oswestry Disability Index (ODI; 12.8). RESULTS: We performed lumbar interbody 
      fusion using an Ag-HA cage for 48 patients (female, n = 25; mean age, 
      67.5 years). The mean preoperative NRS was 6.4 (standard deviation, 1.9), while 
      the mean preoperative ODI was 44 [12]. No adverse effects (i.e., argyria) were 
      identified during the 12-month observation period. Surgical site infection 
      occurred in one case, although the implant was preserved via immediate 
      debridement. In total, 39 (81%) participants showed clinical improvement beyond 
      MCID for both NRS and ODI. Bone fusion was achieved at 45 levels (88%) at 
      6 months and 48 levels (91%) at 12 months postoperatively. CONCLUSIONS: The 
      results of this study suggest that Ag-HA cages can be safely used in spinal 
      fusion procedures and have the potential to prevent postoperative infections, 
      prevent deterioration of the quality of life, and result in favorable outcomes. 
      Larger-scale and longer-term follow-up studies will be required to corroborate 
      these conclusions. Trial registration UMIN 000039964 (date: April 01, 2020).
CI  - (c) 2023. The Author(s).
FAU - Morimoto, Tadatsugu
AU  - Morimoto T
AD  - Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Nabeshima 
      5-1-1, Saga, Japan. morimot3@cc.saga-u.ac.jp.
FAU - Tsukamoto, Masatsugu
AU  - Tsukamoto M
AD  - Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Nabeshima 
      5-1-1, Saga, Japan.
FAU - Aita, Katsuhiro
AU  - Aita K
AD  - Department of Orthopedic Surgery, Saga Memorial Hospital, Saga, Japan.
FAU - Fujita, Nobuyuki
AU  - Fujita N
AD  - Department of Orthopedic Surgery, Faculty of Medicine, Fujita Health University, 
      Aichi, Japan.
FAU - Mawatari, Masaaki
AU  - Mawatari M
AD  - Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Nabeshima 
      5-1-1, Saga, Japan.
LA  - eng
PT  - Journal Article
DEP - 20230530
PL  - England
TA  - J Orthop Surg Res
JT  - Journal of orthopaedic surgery and research
JID - 101265112
RN  - 3M4G523W1G (Silver)
RN  - 91D9GV0Z28 (Durapatite)
SB  - IM
MH  - Humans
MH  - Female
MH  - Aged
MH  - Treatment Outcome
MH  - *Silver
MH  - Durapatite
MH  - Quality of Life
MH  - *Spinal Fusion/adverse effects/methods
MH  - Lumbar Vertebrae/diagnostic imaging/surgery
MH  - Retrospective Studies
PMC - PMC10228124
OTO - NOTNLM
OT  - Hydroxyapatite
OT  - Orthopedic fixation devices
OT  - Silver
OT  - Spinal diseases
OT  - Spinal fusion
OT  - Surgical wound infection
COIS- The authors declare that they have no competing interests.
EDAT- 2023/05/31 01:09
MHDA- 2023/06/01 06:42
PMCR- 2023/05/30
CRDT- 2023/05/30 23:43
PHST- 2022/09/11 00:00 [received]
PHST- 2023/05/26 00:00 [accepted]
PHST- 2023/06/01 06:42 [medline]
PHST- 2023/05/31 01:09 [pubmed]
PHST- 2023/05/30 23:43 [entrez]
PHST- 2023/05/30 00:00 [pmc-release]
AID - 10.1186/s13018-023-03882-7 [pii]
AID - 3882 [pii]
AID - 10.1186/s13018-023-03882-7 [doi]
PST - epublish
SO  - J Orthop Surg Res. 2023 May 30;18(1):392. doi: 10.1186/s13018-023-03882-7.