To determine within-patient fusion rates of chambers filled with bioactive glass versus autologous iliac crest bone on computed tomography (CT) following anterior lumbar interbody fusion (ALIF). A consecutive series of 40 patients (58 levels) that underwent single-level (L5-S1 only) or two-level (L5-S1 and L4-L5) ALIF were assessed. Indications for fusion were one or more of the following: degenerative disc disease with or without Modic changes, spondylolisthesis, and stenosis. Each intervertebral cage had a middle beam delimiting two chambers, one of which was filled with bioactive glass and the other with autologous iliac crest bone. CT scans were graded using the Bridwell classification (grade I, best; grade IV, worst). Patients were evaluated using the Oswestry Disability Index (ODI), and by rating pain in the lower back and legs on a Visual Analog Scale (pVAS); complications and reoperations were noted. At 15 ± 5 months follow-up, there were no significant differences in fusion across chambers filled with bioactive glass versus chambers filled with autologous bone (p = 0.416). Two patients with Bridwell grade III at both chambers of the L4-L5 cages required reoperation using posterior instrumentation. Clinical assessment of the 38 remaining patients (54 levels) at 25 ± 2 months, revealed ODI of 15 ± 12, lower back pVAS of 1.4 ± 1.5 and legs pVAS of 1.9 ± 1.6. For ALIF at L5-S1 or L4-L5, within-patient fusion rates were equivalent for bioactive glass compared to autologous iliac crest bone; thus, bioactive glass can substitute autologous bone, avoiding increased operative time and blood loss, as well as donor site morbidity.

中文翻译：

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与 ALIF 的自体髂嵴骨相比，生物活性玻璃的融合效果相当：一项患者内比较研究

确定在前路腰椎椎间融合 (ALIF) 后计算机断层扫描 (CT) 上填充生物活性玻璃的腔室与自体髂嵴骨的患者内融合率。对接受单级（仅 L5-S1）或两级（L5-S1 和 L4-L5）ALIF 的 40 名患者（58 级）进行了评估。融合的指征是以下一项或多项：伴有或不伴有 Modic 改变的退行性椎间盘疾病、脊椎滑脱和狭窄。每个椎间笼有一个中间横梁划分两个腔室，一个腔室填充生物活性玻璃，另一个腔室填充自体髂嵴骨。CT 扫描使用 Bridwell 分类进行分级（I 级，最佳；IV 级，最差）。使用 Oswestry 残疾指数 (ODI) 对患者进行评估，并通过视觉模拟量表 (pVAS) 评估下背部和腿部的疼痛；注意到并发症和再次手术。在 15 ± 5 个月的随访中，填充生物活性玻璃的腔室与填充自体骨的腔室之间的融合没有显着差异 (p = 0.416)。在 L4-L5 笼的两个腔室中，两名 Bridwell III 级患者需要使用后路器械再次手术。其余 38 名患者（54 个水平）在 25 ± 2 个月时的临床评估显示 ODI 为 15 ± 12，下背部 pVAS 为 1.4 ± 1.5，腿部 pVAS 为 1.9 ± 1.6。对于 L5-S1 或 L4-L5 的 ALIF，与自体髂嵴骨相比，生物活性玻璃的患者内融合率相当；因此，生物活性玻璃可以替代自体骨，避免增加手术时间和失血，以及供区发病率。