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1.
J Neurosurg Spine ; 19(3): 297-300, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23829291

RESUMO

Seroma formation following posterior cervical laminectomy and fusion is now recognized as a rare but significant risk. Previous reports have attributed the development of postoperative seromas to the use of recombinant bone morphogenetic protein-2 (rhBMP-2). Here the authors present the case of a 78-year-old female with a history of osteoporosis who developed delayed postoperative neck and shoulder pain following posterior cervical laminectomy and fusion utilizing only autograft bone and demineralized bone matrix (DBM) allograft. Postoperative MRI demonstrated normal hardware placement and a large epidural fluid collection that extended from C-4 to C-6. The patient underwent decompression and drainage of her sterile postoperative seroma. To the authors' knowledge, no case of seroma formation with the use of DBM has been previously reported. This case suggests that although rhBMP-2 is involved in the majority of postoperative seroma developments, other osteoinductive agents such as DBM can contribute to the development of a symptomatic seroma. This report presents an illustrative case study and reviews the current understanding of the development of and treatment for cervical seroma following posterior cervical laminectomy and fusion.


Assuntos
Proteína Morfogenética Óssea 2 , Transplante Ósseo/efeitos adversos , Laminectomia/efeitos adversos , Seroma/etiologia , Fusão Vertebral/efeitos adversos , Fator de Crescimento Transformador beta , Idoso , Desmineralização Patológica Óssea/etiologia , Desmineralização Patológica Óssea/cirurgia , Proteína Morfogenética Óssea 2/uso terapêutico , Vértebras Cervicais/cirurgia , Feminino , Humanos , Complicações Pós-Operatórias , Proteínas Recombinantes/uso terapêutico , Seroma/patologia , Seroma/cirurgia , Fator de Crescimento Transformador beta/uso terapêutico , Resultado do Tratamento
2.
Rev. esp. investig. quir ; 10(1): 26-32, ene.-mar. 2007. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-87280

RESUMO

INTRODUCCIÓN: Los defectos óseos pueden ser debidos a anomalías congénitas, traumatismos, procesos infecciosos o tumorales,que a menudo se asocian a severos problemas funcionales y/o estéticos, que van a requerir un tratamiento complejo. El objetivo de este estudio fue comparar la formación de hueso nuevo tras la aplicación de una membrana reabsorbible y dos tipos de sustitutivos óseos. MATERIAL Y MÉTODO. Se utilizaron 24 ratas adultas machos tipo Wistar. Se crearon defectos circulares de 4 mm de diámetro en ambos lados de la mandíbula, y fueron divididos en 4 grupos: grupo I, grupo control con defectos vacíos; grupo II, los defectos fueron cubiertos con una membrana de hueso desmineralizado (Lambone®); grupo III, los defectos fueron rellenos con colágeno liofilizado bovino (Colloss®) y cubiertos con Lambone®; grupo IV, los defectos fueron rellenos con vidrio bioactivo (NovaBone®) y cubiertos con Lambone®. Los animales fueron sacrificados a las 3 y 6 semanas de la cirugía, realizándose un análisis radiológico e histológico. RESULTADOS. Los defectos control no mostraron formación ósea, apareciendo una reparación por tejido fibroso. La membrana de hueso utilizada de forma aislada, actuó como una barrera eficaz excluyendo los tejidos no osteogénicos, pero no se produjo reparación total del defecto en ningún caso. El grupo de Colloss® y membrana mostró una regeneración ósea completa del defecto a las 6 semanas. El grupo de NovaBone® y membrana no mostró formación ósea, apareciendo las partículas del biomaterial ocupando el defecto. CONCLUSIONES. La regeneración ósea fue significativamente mayor en los defectos rellenos con Colloss® y cubiertos con la membrana de Lambone®, comparado con los otros grupos experimentales (AU)


INTRODUCTION. Bony defects may be found as a result of congenital anomalies, trauma, neoplasms, or infectious conditions. uch conditions are often associated with severe funtional and esthetic problems. Corrective treatment is often complicated by limitations in tissue adaptations. The aim of this study was to compare the new bone formation following application of a bioabsorbable membrane and two types of bone substitutes. MATERIAL AND METHOD. In the present study, 24 4-month-old male Wistar rats were used. Standardized round through-and-through osseous defect (4 mm in diameter) was created similarly on both sides of the jaw and, were divided in four groups: group I, control defects were left empty; group II, the defects were covered with demineralized laminar bone membrane (Lambone®); group III, defects were filled with bovine bone collagen- protein extracts (Colloss®) and covered with Lambone®; group IV, defects were filled with bioactive glass (NovaBone®) and covered with Lambone®. Animals were killed 3 and 6 weeks after surgery, and healing of the bone defects was assessed by radiologic and histologic analysis. RESULTS. The control defects showed no bone formation, and the holes were filled with fibrous connective tissue. Bone membrane alone acted as an efficient barrier, excluding the nonosteogenic tissues, but new bone formation underneath the membrane was not full. The group of Colloss® and membrane showed complete healing after 6 weeks. The group of NovaBone® and membrane showed no bone formation, appearing the particles in the defect. CONCLUSION. A significantly higher percentage of bone regeneration was seen in the sites filled with Colloss® and covered with Lambone®, compared with the others experimental groups (AU)


Assuntos
Animais , Ratos , Regeneração Óssea/fisiologia , Mandíbula/fisiologia , Substitutos Ósseos/farmacocinética , Regeneração Tecidual Guiada/métodos , Desmineralização Patológica Óssea/cirurgia , Modelos Animais de Doenças , Membranas/fisiologia , Vidro , Colágeno/uso terapêutico
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