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Kevin T. Foley, Eric J. Woodard, Jonathan R. Slotkin, Cassandra K. Mayotte, Abigail C. Baldwin, Michael C. Brown and Brian J. Hess

. Modified Paragon stain, original magnification ×20. Microscopic Observations at 12 Weeks Control Group Kerfs were mostly filled with a dense fibroconnective tissue, which was slightly infiltrated with macrophages. A variable amount of newly formed bone emerged from the kerf margins. Complete bone healing was never observed within the entire circular kerf of the sites. Test Group 1 TTCP-PS appeared as a homogeneous material that had a moderate level of osteointegration. Some newly formed bone and signs of osteoconduction were observed within the TTCP-PS. There were

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Phyo Kim, Hidetoshi Murata, Ryu Kurokawa, Yoshiyuki Takaishi, Keizo Asakuno and Toshiki Kawamoto

, osteoconduction ensues and the implant becomes integrated into the surrounding bones. 10 The trapezoidal-shaped implant has a flange that stabilizes it on the margins of the laminal flaps. The implant also has three tunnels to allow passage of the sutures ( Figs. 1G–I and 3 ). On the medial aspect of the elevated laminal flaps, a passage for the suture is drilled to penetrate the cortical layer parallel to and in between the two plates of the lamina, penetrating the cancellous bone, and exiting to the lateral gutter. The strength of the bone wall to hold the nylon suture is

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Phyo Kim, Susumu Wakai, Seigo Matsuo, Takashi Moriyama and Takaaki Kirino

biocompatibility of this material is well established: it does not provoke a foreign body reaction in vivo and its rate of absorption in situ is very slow. 16 Experimental studies have reproducibly demonstrated bioactive properties of HA; formation of direct bonding with the bone has been confirmed by electron microscopy, and growth of bone on the surface of HA implants (osteoconduction) has been observed. 23 Theoretically, these properties make the use of HA advantageous as a construct material in cervical interbody fusion. Unlike autogeneic or allogeneic bone, HA undergoes

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Dong-Hwa Heo and Sung-Uk Kuh

properties, it is weaker than PMMA in terms of compressive strength and it also requires a long time for osteoconduction. 2 , 6 , 7 Consequently, CPC might not provide as much initial stiffness to compressed osteoporotic vertebrae as PMMA. In our patient the CPC apparently did not provide enough initial stiffness; therefore, a progressive, repeated collapse occurred in the treated vertebra. The patient in our case had severe osteoporosis (T-score on bone densitometry testing, −4.8), which also might have contributed to the progressive, repeated fracture of the treated

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Takeo Goto, Kenji Ohata, Toshihiro Takami, Misao Nishikawa, Naohiro Tsuyuguchi, Michiharu Morino, Yasuhiro Matusaka, Akimasa Nishio, Yuichi Inoue and Mitsuhiro Hara

substitute in oral, plastic, otological, and orthopedic surgery in the past 20 years, and its biocompatibility and safety have been accepted. 4, 5, 7, 35 Several authors have used synthetic HA as a substitute for autologous bone grafts in cervical interbody fusion. 20, 23 The authors of experimental studies have demonstrated that bone union around porous HA is formed in two ways: bone ingrowth into the pores and formation of bridging bone on the surface of the implant (osteoconduction). 1, 34 Akino 1 used porous material to perform anterior fusion in a dog model and

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Takashiro Ohyama, Yoshichika Kubo, Hiroo Iwata and Waro Taki

loosening, which can lead to incomplete arthrodesis. In addition, the ideal bone substitute is a material that can be thoroughly replaced by new bone after serving its purpose of osteoconduction. It has been shown that TCP degraded more quickly than HA. Shors, et al., 30 have reported that TCP degraded to trace amounts at 2 months after implantation and completely disappeared after several months. In light of these findings, we chose TCP as a packing material for the interbody fusion cage. As expected, the TCP-filled cages provide a histologically proven union rate

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G. Bryan Cornwall, Donna L. Wheeler, Kevin A. Thomas, William R. Taylor and A. Simon Turner

323–341 18. Lemperle SM , Calhoun CJ , Curran RW , et al : Bony healing of large cranial and mandibular defects protected from soft-tissue interposition: a comparative study of spontaneous bone regeneration, osteoconduction, and cancellous autografting in dogs. Plastic Reconstr Surg 101 : 660 – 672 , 1998 Lemperle SM, Calhoun CJ, Curran RW, et al: Bony healing of large cranial and mandibular defects protected from soft-tissue interposition: a comparative study of spontaneous bone regeneration, osteoconduction, and

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Ashley R. Poynton, Fengyu Zheng, Emre Tomin, Joseph M. Lane and G. Bryan Cornwall

containing recombinant human bone morphogenetic protein-2. J Oral Maxillofac Surg 57 : 695 – 698 , 1999 Isobe M, Yamazaki Y, Mori M, et al: Bone regeneration produced in rat femur defects by polymer capsules containing recombinant human bone morphogenetic protein-2. J Oral Maxillofac Surg 57: 695–698, 1999 8. Lemperle SM , Calhoun CJ , Curran RW , et al : Bony healing of large cranial and mandibular defects protected from soft tissue interposition: a comparative study of spontaneous bone regeneration, osteoconduction, and

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Christopher C. Gillis, John T. Street, Michael C. Boyd and Charles G. Fisher

physiological manner similar to a fracture, with quicker remodeling, minimal resorption of the bone, and secondary remodeling 13 along areas of increased stress, thus providing a biomechanically superior construct. The donor-site morbidity associated with the use of a vascularized fibula graft is acceptable, and with biomechanical remodeling a single graft rather than multiple barreled grafts can be used. A vascularized autograft encompasses all of the key factors for bone repair: osteogenesis, osteoinduction, and osteoconduction; cadaveric autograft was also used, which

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Zia E. Taheri and Monoucher Gueramy

substitution. In considering the quality of bone for fusion, the following factors are important or necessary: 11 1. Osteogenic capacity. The ability of an implant to form new bone by virtue of the bone-forming cells within its substance. 2. Osteogenic inductive potency. The ability of an implant to induce adjacent connective tissue to form bone. 3. Osteoconduction. The ability of the implant, by virtue of its structure, to form a lattice-work or template along which new bone is laid. 4. Splintage and protective mechanism. The ability of