Successful Bone Graft Research Articles

The Management of Tumors of the Upper Cervical Spine

Summary Tumors of the atlas and axis are exceedingly uncommon lesions. A review of the literature provided 28 cases, of which two-thirds were the result of metastatic processes. Benign endoplasms in this region may cause serious sequelae resulting from impingement upon the lower brainstem, upper cervical cord, and vertebral arteries. Vigorous therapeutic endeavors should be undertaken with the aim of achieving complete amelioration of pain, reversal of neurologic impairment, and attainment of cervical stability. Although the underlying disease process in the majority of patients may be a terminal condition, improved longevity combined with the presence of disabling pain and neurologic compromise demands carefully planned treatment. Important points discussed include the following: 1. It is necessary to establish tissue diagnosis by the appropriate method. The transpharyngeal needle biopsy of Ottolenghi is a safe and dependable method for obtaining tissue from the anterior elements of C1 and C2. 2. Cord compression may result from two basic mechanisms, and it is necessary to resort to cervical myelography to distinguish between the two. 3. Flexion and extension views, cineradiography, angiography, and tomography may assist in patient evaluation. 4. Guidelines for planning the surgical approach are offered, as well as preferred exposure techniques. 5. Anterior surgery in this region is a major undertaking and should be reserved for patients with benign anterior tumors or cancer patients with a good prognosis and specific indications. 6. Tracheostomy should be carried out to avoid postoperative complications after anterior surgery. 7. Whenever possible, bone grafting should be used to establish cervical fusion. Several drawbacks to successful bone grafting exist in the case of metastatic disease. Some of these factors may be circumvented with the use of methyl methacrylate alone or in combination with a bone graft. Acrylic also allows early postoperative ambulation without the need for cumbersome external immobilization devices.

The early detection of free bone graft viability with 99mTc: A preliminary report

Scintiscanning 3 hours following a small injection of 99mTc will indicate a metabolically successful bone graft by the 4th postoperative week.

Congenital Pseudarthrosis of the Tibia-Treatment by Tibial Lengthening and Corrective Osteotomy Seven Years After Successful Bone Graft

Congenital Pseudarthrosis of the Tibia-Treatment by Tibial Lengthening and Corrective Osteotomy Seven Years After Successful Bone Graft

The function of the donor tissue in experimental operations with radioactive bone grafts.

The experiments show, with the aid of radioisotope labeled rabbit bone transplants into clean hosts, that the donor tissue can accomplish its purpose (to induce the host to fill a defect, to fuse a joint, to unite a fracture) when less than one-third of its total mass has been absorbed and replaced by the host. The bone matrix and the bone mineral are absorbed together and the labeled mineral constituents are dissolved and carried into the systemic circulation of the host and not transferred locally to the host bed. When a bone graft takes,'' the donor tissue becomes adjoined to the host by a cement line formed by the host by condensation of mucopolysaccharides with the histochemical characteristics of chondroitin sulfate. When a bone graft operation fails, the donor tissue becomes encapsulated in an envelope of fibrous tissue and is virtually outside the body. In a successful bone graft the host grows into the donor tissue in an orderly pattern and not by haphazard growth; the trabeculae of new bone from the host bed grow into the donor and each one finds a trabocula of deal bone on which to attach itself in the most efficient way; thus the functionmore » of the donor tissue in all bone graft operations is to provide a network of slowly absorbed surfaces upon which the host is induced to condense the cement line and deposit the new bone. The induction of new bone formation by a bone transfer is a non-specific reaction, the mechanism of which is not yet known, and requires further investigation.« less