The Successes of CBA’s in Arthrodesis

Within the next decade, the number of arthrodesis procedures is expected to continue to increase due to aging populations and complex combinations of diseases in individuals. The goals of arthrodesis procedures are to decrease pain, increase mobility, and improve one’s overall quality of life.

Arthrodesis typically focuses on the reversal of disability associated with arthritis, trauma, diabetes, instability, or misalignment in joints, and successful procedures can depend on numerous risk factors. Considerations you should take into account beforehand include levels of tobacco or alcohol abuse, osteoporosis, use of anti-inflammatory drugs, age, and weight.

The quantity of autograft is sometimes limited, and the bone quality can be poor. This is especially common in older patients and those with a combination of physical difficulties. A second surgery may be required to reduce pain and improve mobility in these individuals, though a variety of bone graft substitutes have since been developed. These new developments range from synthetic matrices, to bone marrow aspirates, though, until recently, none of these substitutes consisted of bone-forming cells.

Breaking down cellular bone allografts (CBA’s), they biologically provide three properties that are necessary for proper bone formation. These include osteoconductive scaffolds, osteoinductive growth factors, and osteogenic cells. Orthofix’s Trinity Elite is a cryopreserved CBA that contains at least 500,000 living cells per CC, the donors of which are strictly screened by MTF based on multiple criteria like age and overall health. In the end, less than 3% of donors are accepted, showing how high the standards are for those that wish donate.

In order to measure CBA’s effects in arthrodesis procedures, a clinical trial was performed for 103 patients undergoing foot and/or ankle arthrodesis, of which were enrolled at 10 institutions and at least 18 years of age. The patients varied for their needs to undergo the procedure, ranging from arthritis, to deformities, to degenerative joint disease. 92 of these individuals successfully completed their 6-month follow-ups after the procedures were done, the primary endpoint being successful fusion after this time, following CT scans that confirmed such findings.

 
To simulate real life scenarios, patients considered high-risk were not excluded from the study. The use of CBA’s did not raise any concerns in terms of safety seeing as there were no adverse effects or infections in those that participated either. Statistically significant improvements in pain and function were noted at the end of the study, which notably improved throughout the entire process, thus showing the success CBA’s have in arthrodesis procedures.

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The Benefits of Spinal Surgery

According to the American Chiropractic Association, 31 million Americans experience lower back pain, and an estimated 80% of the United States population will endure some type of back problem at some point in their lives. For those people, finding the source of this pain is crucial in order to properly combat it, as well as prevent any future occurrences.

Back pain can be caused by poor habits or health including things like posture, improper exercise, and obesity, all of which put stress on the muscles of the vertebral column. However, spinal abnormalities can be categorized as either mechanical (mentioned above), or neurological. Neurological abnormalities of the spine involve nerve root pain, compression, or tumors. The treatment, regardless of the underlying causes, typically includes physical therapy, massages, or general medication in an attempt to relieve symptoms. In extreme cases, when standard remedies have failed, spinal surgery may be required.

If a patient is experiencing chronic pain and has a treatable spinal abnormality, surgery of the spine can be extremely beneficial. Minimally invasive techniques, which require very small incisions, cause significantly less damage to the surrounding tissue than standard operating procedures. Using a tubular retractor, surgeons are able to access the spine through the skin and soft tissue with a much smaller incision required than open surgery. This retractor holds the muscles open while the surgeon performs the necessary surgery with small tools that fit through the opening of the retractor, guided by fluoroscopy; a video of the spine projected on a screen throughout the process. Once completed, the tubular retractor is removed and the muscles are able to return to their original positions with minimal damage.

The benefits of this procedure include a faster recovery time by the patient, and much less pain following surgery. However, it’s important to note that minimally invasive techniques are not preferred for traumatic situations, tumors, or infections.

Once returning to full activity, patients are to follow a strict regimen to ensure proper recovery. Avoiding lifting heavy objects and bending or twisting at the waist is highly recommended to avoid undoing that which was done during the surgery. Working closely with a physical therapist to develop an efficient rehabilitation program should also be considered, with the ultimate goal to return to one’s daily activities without being restricted by back or neck pain.

Spinal surgery, while not always necessary, can greatly help in reducing or relieving a patient’s back pain. It is, however, important to understand that with benefits comes risks. Infections, blood clots, or herniated disks are possible reactions post back surgery, the odds of which vary depending on one’s health conditions.

For those with persistent back pain, talk to your doctor about the treatments available before you consider surgery. Though it can be extremely beneficial, it is not always suggested, as circumstances may differ. Should you choose to take that next step in relieving back pain, spinal surgery may also provide increased physical fitness, better mobility, and an overall improvement in mood; just some of the many betterments possible.