In spinal surgery, anterior spondylodesis is often combined with bone grafting, and graft integra... more In spinal surgery, anterior spondylodesis is often combined with bone grafting, and graft integration is assessed with CT. High-resolution peripheral quantitative CT offers a resolution of 82 mum. The aim of this study was to compare the outcome of anterior spondylodesis as assessed with three radiologic procedures. Monosegmental lumbar spondylodesis with autologous iliac crest graft or solvent-preserved bovine cancellous bone was performed on seven sheep. The fused spinal segments were explanted after 24 weeks and examined with clinical 64-MDCT, high-resolution peripheral quantitative CT, and contact radiography. In 2D views, the area of the disk space bridged by bone was assessed, and the grafts were examined for fractures. In three of seven sheep, clinical CT erroneously showed stable consolidation, whereas contact radiography revealed a clearly visible graft fracture, as did high-resolution peripheral quantitative CT. There was a statistically significant difference (p = 0.038) between bone volume assessed with clinical CT and that assessed with contact radiography. There was an almost significant difference (p = 0.053) between volumes assessed with high-resolution peripheral quantitative CT and clinical MDCT. High-resolution peripheral quantitative CT, a technique approved for clinical use, has higher resolution in imaging of bone structure than does 64-MDCT. Our results show that high-resolution peripheral quantitative CT is superior to 64-MDCT in assessing osseous implant integration after anterior spondylodesis. The specimen size limit, however, prohibits in vivo use of this method in evaluation of the human spine. Our results suggest that in clinical practice, persisting symptoms despite radiologic findings of consolidated spondylodesis may be related to graft failure, which cannot be detected with clinically available methods.
Revue de Chirurgie Orthopédique et Traumatologique, 2015
ABSTRACT A common method to restore the sagittal alignment and stabilize the spinal column is a d... more ABSTRACT A common method to restore the sagittal alignment and stabilize the spinal column is a dorso-ventral spondylodesis. It is assumed that correction loss after posttraumatic spondylodesis results from inadequate incorporation of the autologous iliac crest graft.
Orthopaedics & traumatology, surgery & research : OTSR, 2015
A common method to restore the sagittal alignment and stabilize the spinal column is a dorso-vent... more A common method to restore the sagittal alignment and stabilize the spinal column is a dorso-ventral spondylodesis. It is assumed that correction loss after posttraumatic spondylodesis results from inadequate incorporation of the autologous iliac crest graft. Retrospective documentation of patients with unstable vertebral body fractures of the thoracic or lumbar spine with concomitant rupture of at least one adjacent intervertebral disk who received surgical treatment at our institution from 2000 to 2006. Followed by analysis of the computer tomography documentation of a total of 142 patients with unstable vertebral body fracture stabilized by posterior internal fixator and anterior iliac crest spondylodesis. The following mean angle changes were derived from the second series of CT scans performed on average 283 days after anterior spondylodesis: vertebral wedge angle (VWA): 2.1°; segmental kyphotic angle: 4.9°; adjusted-SKA: 4.8°; sagittal index (SI): -0.04; segmental-scoliotic-an...
The American journal of sports medicine, Jan 16, 2014
There are several reports on long-term clinical outcomes after autologous chondrocyte implantatio... more There are several reports on long-term clinical outcomes after autologous chondrocyte implantation (ACI) for knee cartilage defect treatment. Few published articles have evaluated defect quality using quantitative magnetic resonance (MR) imaging techniques. To evaluate clinical outcomes and the quality of repair tissue (RT) after first-generation periosteum-covered ACI (ACI-P) using qualitative MR outcomes and T2-weighted relaxation times. Case series; Level of evidence, 4. All patients (n = 86) who underwent knee joint ACI-P (from 1997 through 2001) with a postoperative follow-up of at least 10 years were invited for clinical and MR evaluation. Clinical outcomes analysis included pre- and postoperative Lysholm and numeric analog scale (NAS) for pain (10 = worst, 0 = best). Radiographic analysis included postoperative T2-weighted mapping of the RT, RT-associated regions, and healthy control cartilage; MOCART (magnetic resonance observation of cartilage repair tissue) score; a modifi...
Technology and health care : official journal of the European Society for Engineering and Medicine, 2013
Anterior spondylodesis with bone grafting for fusion of spinal motion segments is a common proced... more Anterior spondylodesis with bone grafting for fusion of spinal motion segments is a common procedure in clinical routine. Bone grafts for fusion include autologous, allogenic and xenogenic grafts that are inserted in the unstable spinal motion segment. Nevertheless, biomechanical data for autologous, allogenic and xenogenic grafts are rare. The purpose of this study was to conduct biomechanical comparison of native and conserved bone grafts used in spondylodesis of the spine. Grafts examined were native ovine tricortical iliac crest grafts, bovine cancellous bone blocks and ovine, tricortical iliac crest grafts, conserved in the same way as the bovine cancellous bone blocks. The grafts were tested biomechanically to failure. Compared parameters were maximum torque, maximum rotation angle and graft stiffness at failure. The Mann-Whitney-U test with Bonferroni adjustment was used for statistical analysis. Maximum torque at failure of the bovine cancellous bone graft did not differ sig...
The objective of this study was the radiological evaluation of osseous integration of autologous ... more The objective of this study was the radiological evaluation of osseous integration of autologous iliac crest graft and bovine bone graft after spondylodesis based on a standardized score. Spondylodesis was performed on 18 sheep, divided into 2 groups, 1 with an autologous iliac crest graft and the other with a bovine bone graft. Computed tomography was performed 12 and 24 weeks postoperatively. The osseous integration was assessed by the Tübinger Score. The evaluation of the CT scans demonstrated a significantly better osseous integration of the autologous iliac crest graft compared to the bovine bone graft. Based on our results, the bovine bone graft as a transplant for spondylodesis is inadvisable.
In spinal surgery, anterior spondylodesis is often combined with bone grafting, and graft integra... more In spinal surgery, anterior spondylodesis is often combined with bone grafting, and graft integration is assessed with CT. High-resolution peripheral quantitative CT offers a resolution of 82 mum. The aim of this study was to compare the outcome of anterior spondylodesis as assessed with three radiologic procedures. Monosegmental lumbar spondylodesis with autologous iliac crest graft or solvent-preserved bovine cancellous bone was performed on seven sheep. The fused spinal segments were explanted after 24 weeks and examined with clinical 64-MDCT, high-resolution peripheral quantitative CT, and contact radiography. In 2D views, the area of the disk space bridged by bone was assessed, and the grafts were examined for fractures. In three of seven sheep, clinical CT erroneously showed stable consolidation, whereas contact radiography revealed a clearly visible graft fracture, as did high-resolution peripheral quantitative CT. There was a statistically significant difference (p = 0.038) between bone volume assessed with clinical CT and that assessed with contact radiography. There was an almost significant difference (p = 0.053) between volumes assessed with high-resolution peripheral quantitative CT and clinical MDCT. High-resolution peripheral quantitative CT, a technique approved for clinical use, has higher resolution in imaging of bone structure than does 64-MDCT. Our results show that high-resolution peripheral quantitative CT is superior to 64-MDCT in assessing osseous implant integration after anterior spondylodesis. The specimen size limit, however, prohibits in vivo use of this method in evaluation of the human spine. Our results suggest that in clinical practice, persisting symptoms despite radiologic findings of consolidated spondylodesis may be related to graft failure, which cannot be detected with clinically available methods.
In spinal surgery, anterior spondylodesis is often combined with bone grafting, and graft integra... more In spinal surgery, anterior spondylodesis is often combined with bone grafting, and graft integration is assessed with CT. High-resolution peripheral quantitative CT offers a resolution of 82 mum. The aim of this study was to compare the outcome of anterior spondylodesis as assessed with three radiologic procedures. Monosegmental lumbar spondylodesis with autologous iliac crest graft or solvent-preserved bovine cancellous bone was performed on seven sheep. The fused spinal segments were explanted after 24 weeks and examined with clinical 64-MDCT, high-resolution peripheral quantitative CT, and contact radiography. In 2D views, the area of the disk space bridged by bone was assessed, and the grafts were examined for fractures. In three of seven sheep, clinical CT erroneously showed stable consolidation, whereas contact radiography revealed a clearly visible graft fracture, as did high-resolution peripheral quantitative CT. There was a statistically significant difference (p = 0.038) between bone volume assessed with clinical CT and that assessed with contact radiography. There was an almost significant difference (p = 0.053) between volumes assessed with high-resolution peripheral quantitative CT and clinical MDCT. High-resolution peripheral quantitative CT, a technique approved for clinical use, has higher resolution in imaging of bone structure than does 64-MDCT. Our results show that high-resolution peripheral quantitative CT is superior to 64-MDCT in assessing osseous implant integration after anterior spondylodesis. The specimen size limit, however, prohibits in vivo use of this method in evaluation of the human spine. Our results suggest that in clinical practice, persisting symptoms despite radiologic findings of consolidated spondylodesis may be related to graft failure, which cannot be detected with clinically available methods.
Revue de Chirurgie Orthopédique et Traumatologique, 2015
ABSTRACT A common method to restore the sagittal alignment and stabilize the spinal column is a d... more ABSTRACT A common method to restore the sagittal alignment and stabilize the spinal column is a dorso-ventral spondylodesis. It is assumed that correction loss after posttraumatic spondylodesis results from inadequate incorporation of the autologous iliac crest graft.
Orthopaedics & traumatology, surgery & research : OTSR, 2015
A common method to restore the sagittal alignment and stabilize the spinal column is a dorso-vent... more A common method to restore the sagittal alignment and stabilize the spinal column is a dorso-ventral spondylodesis. It is assumed that correction loss after posttraumatic spondylodesis results from inadequate incorporation of the autologous iliac crest graft. Retrospective documentation of patients with unstable vertebral body fractures of the thoracic or lumbar spine with concomitant rupture of at least one adjacent intervertebral disk who received surgical treatment at our institution from 2000 to 2006. Followed by analysis of the computer tomography documentation of a total of 142 patients with unstable vertebral body fracture stabilized by posterior internal fixator and anterior iliac crest spondylodesis. The following mean angle changes were derived from the second series of CT scans performed on average 283 days after anterior spondylodesis: vertebral wedge angle (VWA): 2.1°; segmental kyphotic angle: 4.9°; adjusted-SKA: 4.8°; sagittal index (SI): -0.04; segmental-scoliotic-an...
The American journal of sports medicine, Jan 16, 2014
There are several reports on long-term clinical outcomes after autologous chondrocyte implantatio... more There are several reports on long-term clinical outcomes after autologous chondrocyte implantation (ACI) for knee cartilage defect treatment. Few published articles have evaluated defect quality using quantitative magnetic resonance (MR) imaging techniques. To evaluate clinical outcomes and the quality of repair tissue (RT) after first-generation periosteum-covered ACI (ACI-P) using qualitative MR outcomes and T2-weighted relaxation times. Case series; Level of evidence, 4. All patients (n = 86) who underwent knee joint ACI-P (from 1997 through 2001) with a postoperative follow-up of at least 10 years were invited for clinical and MR evaluation. Clinical outcomes analysis included pre- and postoperative Lysholm and numeric analog scale (NAS) for pain (10 = worst, 0 = best). Radiographic analysis included postoperative T2-weighted mapping of the RT, RT-associated regions, and healthy control cartilage; MOCART (magnetic resonance observation of cartilage repair tissue) score; a modifi...
Technology and health care : official journal of the European Society for Engineering and Medicine, 2013
Anterior spondylodesis with bone grafting for fusion of spinal motion segments is a common proced... more Anterior spondylodesis with bone grafting for fusion of spinal motion segments is a common procedure in clinical routine. Bone grafts for fusion include autologous, allogenic and xenogenic grafts that are inserted in the unstable spinal motion segment. Nevertheless, biomechanical data for autologous, allogenic and xenogenic grafts are rare. The purpose of this study was to conduct biomechanical comparison of native and conserved bone grafts used in spondylodesis of the spine. Grafts examined were native ovine tricortical iliac crest grafts, bovine cancellous bone blocks and ovine, tricortical iliac crest grafts, conserved in the same way as the bovine cancellous bone blocks. The grafts were tested biomechanically to failure. Compared parameters were maximum torque, maximum rotation angle and graft stiffness at failure. The Mann-Whitney-U test with Bonferroni adjustment was used for statistical analysis. Maximum torque at failure of the bovine cancellous bone graft did not differ sig...
The objective of this study was the radiological evaluation of osseous integration of autologous ... more The objective of this study was the radiological evaluation of osseous integration of autologous iliac crest graft and bovine bone graft after spondylodesis based on a standardized score. Spondylodesis was performed on 18 sheep, divided into 2 groups, 1 with an autologous iliac crest graft and the other with a bovine bone graft. Computed tomography was performed 12 and 24 weeks postoperatively. The osseous integration was assessed by the Tübinger Score. The evaluation of the CT scans demonstrated a significantly better osseous integration of the autologous iliac crest graft compared to the bovine bone graft. Based on our results, the bovine bone graft as a transplant for spondylodesis is inadvisable.
In spinal surgery, anterior spondylodesis is often combined with bone grafting, and graft integra... more In spinal surgery, anterior spondylodesis is often combined with bone grafting, and graft integration is assessed with CT. High-resolution peripheral quantitative CT offers a resolution of 82 mum. The aim of this study was to compare the outcome of anterior spondylodesis as assessed with three radiologic procedures. Monosegmental lumbar spondylodesis with autologous iliac crest graft or solvent-preserved bovine cancellous bone was performed on seven sheep. The fused spinal segments were explanted after 24 weeks and examined with clinical 64-MDCT, high-resolution peripheral quantitative CT, and contact radiography. In 2D views, the area of the disk space bridged by bone was assessed, and the grafts were examined for fractures. In three of seven sheep, clinical CT erroneously showed stable consolidation, whereas contact radiography revealed a clearly visible graft fracture, as did high-resolution peripheral quantitative CT. There was a statistically significant difference (p = 0.038) between bone volume assessed with clinical CT and that assessed with contact radiography. There was an almost significant difference (p = 0.053) between volumes assessed with high-resolution peripheral quantitative CT and clinical MDCT. High-resolution peripheral quantitative CT, a technique approved for clinical use, has higher resolution in imaging of bone structure than does 64-MDCT. Our results show that high-resolution peripheral quantitative CT is superior to 64-MDCT in assessing osseous implant integration after anterior spondylodesis. The specimen size limit, however, prohibits in vivo use of this method in evaluation of the human spine. Our results suggest that in clinical practice, persisting symptoms despite radiologic findings of consolidated spondylodesis may be related to graft failure, which cannot be detected with clinically available methods.
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