About all

Spongiosis of the spine. Spondylosis: Understanding Spinal Degeneration and Treatment Options

by alexxlab

What is spondylosis. How does it affect the spine. What are the common symptoms of spondylosis. What treatment options are available for managing spondylosis. How is spondylosis diagnosed. Can spondylosis be prevented. What lifestyle changes can help alleviate spondylosis symptoms.

What is Spondylosis and How Does it Affect the Spine?

Spondylosis is a broad term used to describe degenerative changes in the spine that occur as a natural part of aging. It refers to wear and tear of the spinal discs, vertebrae, and associated structures. While often used to specifically indicate osteoarthritis of the spine, spondylosis can encompass various degenerative spinal conditions.

How exactly does spondylosis impact the spine? The degenerative process typically involves:

  • Dehydration and loss of height in the intervertebral discs
  • Formation of bone spurs (osteophytes) on vertebrae
  • Thickening of spinal ligaments
  • Potential narrowing of the spinal canal (spinal stenosis)

These changes can affect the normal structure and function of the spine, potentially leading to pain and other symptoms. However, it’s important to note that many people with spondylosis on imaging studies may not experience any symptoms.

Common Symptoms and Manifestations of Spondylosis

While spondylosis doesn’t always cause noticeable symptoms, when it does, they can vary depending on the location and severity of the spinal degeneration. Common symptoms may include:

  • Localized pain in the affected area of the spine
  • Stiffness, especially after periods of inactivity
  • Muscle weakness or numbness if nerves are affected
  • Reduced range of motion in the spine
  • Headaches (particularly with cervical spondylosis)

Can spondylosis cause radiating pain? In some cases, yes. If the degenerative changes compress or irritate spinal nerves, it can lead to radicular pain that travels along the path of the affected nerve. For example, cervical spondylosis might cause arm pain, while lumbar spondylosis could result in leg pain or sciatica.

Diagnosing Spondylosis: From Symptoms to Imaging

Accurate diagnosis of spondylosis involves a combination of clinical evaluation and diagnostic imaging. The process typically includes:

  1. Medical history review
  2. Physical examination
  3. Neurological assessment
  4. Imaging studies (X-rays, MRI, or CT scans)

How do doctors differentiate spondylosis from other spinal conditions? While imaging can reveal degenerative changes, it’s crucial to correlate these findings with the patient’s symptoms and clinical presentation. This is because not all degenerative changes seen on imaging are necessarily the source of pain or discomfort.

The Role of Advanced Imaging in Spondylosis Diagnosis

Advanced imaging techniques play a crucial role in diagnosing and characterizing spondylosis. MRI (Magnetic Resonance Imaging) is particularly useful as it provides detailed images of soft tissues, including intervertebral discs and spinal nerves. This can help identify specific issues such as disc herniations or spinal stenosis that may be contributing to symptoms.

Treatment Approaches for Managing Spondylosis

The management of spondylosis aims to alleviate pain, improve function, and prevent further degeneration. Treatment options range from conservative measures to surgical interventions in severe cases. Common approaches include:

  • Physical therapy and exercise
  • Pain management techniques
  • Medications (NSAIDs, muscle relaxants)
  • Lifestyle modifications
  • Interventional procedures (epidural injections)
  • Surgery (in select cases)

How effective are non-surgical treatments for spondylosis? Many patients find significant relief through conservative measures. A combination of physical therapy, targeted exercises, and pain management techniques can often provide substantial improvement in symptoms and quality of life.

The Role of Physical Therapy in Spondylosis Management

Physical therapy plays a crucial role in managing spondylosis symptoms and improving overall spinal health. A tailored physical therapy program may include:

  • Strengthening exercises for core and spinal muscles
  • Flexibility and range of motion exercises
  • Posture correction techniques
  • Manual therapy to improve joint mobility
  • Education on proper body mechanics

These interventions aim to improve spinal stability, reduce pain, and enhance overall function, potentially slowing the progression of spondylosis.

Lifestyle Modifications to Alleviate Spondylosis Symptoms

Making certain lifestyle changes can significantly impact the management of spondylosis and potentially slow its progression. Key modifications include:

  • Maintaining a healthy weight to reduce stress on the spine
  • Adopting proper ergonomics at work and home
  • Regular exercise to improve flexibility and strength
  • Quitting smoking, which can accelerate disc degeneration
  • Managing stress through relaxation techniques

How significant is the impact of weight management on spondylosis symptoms? Excess weight places additional stress on the spine, potentially exacerbating spondylosis symptoms. Maintaining a healthy weight through proper diet and exercise can significantly reduce this stress, often leading to notable symptom improvement.

The Importance of Ergonomics in Spondylosis Management

Proper ergonomics play a crucial role in managing spondylosis, particularly for those who spend long hours sitting or performing repetitive tasks. Key ergonomic considerations include:

  • Using a chair with proper lumbar support
  • Maintaining correct posture while sitting and standing
  • Adjusting computer monitors to eye level
  • Taking regular breaks to move and stretch
  • Using ergonomic tools and equipment when possible

Implementing these ergonomic principles can help reduce strain on the spine, potentially alleviating spondylosis symptoms and slowing the progression of spinal degeneration.

Surgical Interventions for Severe Spondylosis Cases

While most cases of spondylosis respond well to conservative treatment, surgery may be considered in severe cases where non-surgical approaches have failed to provide adequate relief. Surgical options may include:

  • Decompression procedures (laminectomy, foraminotomy)
  • Spinal fusion
  • Disc replacement
  • Minimally invasive techniques

When is surgery typically recommended for spondylosis? Surgical intervention is usually considered when there is significant nerve compression causing persistent pain, weakness, or numbness, or when the condition severely impacts daily activities and quality of life despite conservative treatments.

Advancements in Minimally Invasive Spine Surgery

Recent advancements in minimally invasive spine surgery techniques have expanded the options for treating severe spondylosis. These procedures offer several potential benefits:

  • Smaller incisions and less tissue damage
  • Reduced blood loss during surgery
  • Faster recovery times
  • Lower risk of complications
  • Shorter hospital stays

While not suitable for all cases, minimally invasive approaches can provide effective relief for many patients with severe spondylosis who require surgical intervention.

Preventing Spondylosis: Strategies for Maintaining Spinal Health

While some degree of spinal degeneration is a natural part of aging, there are steps individuals can take to potentially slow the progression of spondylosis and maintain overall spinal health:

  • Regular exercise to strengthen core and back muscles
  • Maintaining proper posture and body mechanics
  • Staying hydrated to support disc health
  • Consuming a balanced diet rich in calcium and vitamin D
  • Avoiding smoking and excessive alcohol consumption
  • Managing stress through relaxation techniques

How effective are preventive measures in reducing the risk of spondylosis? While these strategies cannot completely prevent spondylosis, they can help maintain overall spinal health and potentially slow the degenerative process. Adopting these habits early in life and maintaining them consistently can contribute to better long-term spinal health.

The Role of Nutrition in Spinal Health

Proper nutrition plays a crucial role in maintaining spinal health and potentially slowing the progression of spondylosis. Key nutritional considerations include:

  • Adequate calcium and vitamin D intake for bone health
  • Omega-3 fatty acids for their anti-inflammatory properties
  • Antioxidant-rich foods to combat oxidative stress
  • Collagen-boosting nutrients for disc and ligament health
  • Proper hydration to maintain disc hydration

A balanced diet that includes these nutrients can support overall spinal health and potentially help manage spondylosis symptoms.

Living with Spondylosis: Coping Strategies and Quality of Life

Living with spondylosis can present challenges, but many individuals are able to maintain a good quality of life with proper management. Key coping strategies include:

  • Adhering to prescribed treatment plans
  • Practicing stress management techniques
  • Engaging in regular, appropriate exercise
  • Using assistive devices when necessary
  • Joining support groups or seeking counseling

How can individuals with spondylosis maintain an active lifestyle? With proper guidance from healthcare professionals, many people with spondylosis can continue to engage in modified forms of their favorite activities. This might involve adjusting techniques, using supportive equipment, or exploring alternative low-impact exercises.

The Importance of Mental Health in Spondylosis Management

Managing the psychological aspects of living with a chronic condition like spondylosis is crucial for overall well-being. Strategies to support mental health include:

  • Practicing mindfulness and meditation
  • Engaging in cognitive-behavioral therapy
  • Maintaining social connections and support systems
  • Setting realistic goals and celebrating small victories
  • Exploring hobbies and activities that bring joy and fulfillment

Addressing both the physical and emotional aspects of spondylosis can lead to improved overall quality of life and better management of the condition.

Spondylosis: What It Actually Means

Spondylosis is a broad term that simply refers to some type of degeneration in the spine.

Spondylosis is an umbrella term used to describe pain from degenerative conditions of the spine. Watch: Spondylosis Video

Most often, the term spondylosis is used to describe osteoarthritis of the spine, but it is also commonly used to describe any manner of spinal degeneration.

advertisement

Spondylosis Is a Descriptive Term

As with many other terms to describe spinal problems, spondylosis is more of a descriptive term than it is a clinical diagnosis. Literally it can be translated to mean that one has both pain and spine degeneration, regardless of what is causing the pain or where the degeneration is occurring.

Watch: Video: What Is a Degenerative Disc and the Degenerative Cascade?

For example:

  • The patient may have pain from facet joint osteoarthritis, causing pain during times of high activity or after extended inactivity
  • There could be spinal stenosis, an abnormal narrowing of the spinal canal, which is creating leg pain when the patient walks
  • The pain could be caused by degenerative disc disease, in which a degenerated disc that becomes dehydrated and loses some of its function. The degenerated disc can cause low back pain or neck pain, and possibly leg pain or arm pain.

These examples are only a few of the many possible contributors to a patient’s pain.

See When Back Pain May Be a Medical Emergency

In This Article:

  • Spondylosis: What It Actually Means

  • Answers to Common Spondylosis Questions

  • Spondylosis Video

After arriving at a confirmed clinical diagnosis for the cause of a patient’s pain (rather than just the finding that there is spondylosis, which may or may not be causing the pain), physicians then usually use more specific terms for the diagnosis (such as osteoarthritis, lumbar degenerative disc disease or cervical degenerative disc disease, or lumbar spinal stenosis or cervical spinal stenosis) because those terms more effectively describe what is causing the pain.

Dr. David DeWitt is an orthopedic surgeon practicing at the NeuroSpine Center of Wisconsin, where he specializes in spine surgery. He has more than 15 years of experience evaluating and treating spine diseases and trauma.

  • Share on Facebook
  • Share on Pinterest
  • Share on Twitter
  • Subscribe to our newsletter

  • Email this article

advertisement

Editor’s Top Picks

  • Spondylolysis and Spondylolisthesis

  • Facet Joint Osteoarthritis

  • Living with Degenerative Disc Disease

  • Spondylosis Video

  • Lumbar Osteoarthritis Video

  • Lumbar Degenerative Disc Disease Video

Lumbar spondylosis: clinical presentation and treatment approaches

1. Frymoyer JW. Back pain and sciatica. N Engl J Med. 1988;318:291–300. [PubMed] [Google Scholar]

2. van Geen J, Edelaar M, Janssen M, et al. The long-term effect of multidisciplinary back training: a systematic review. Spine. 2007;32(2):249–55. doi: 10.1097/01.brs.0000251745.00674.08. [PubMed] [CrossRef] [Google Scholar]

3. Andersson GB. Epidemiological features of chronic low pain. Lancet. 1999;354:581–5. doi: 10.1016/S0140-6736(99)01312-4. [PubMed] [CrossRef] [Google Scholar]

4. Dillane J, Fry J, Kalton G. Acute back syndrome—a study from general practice. Br Med J. 1966;2:82–4. doi: 10.1136/bmj.2.5505.82. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

5. Andersson HI, Ejlertsson G, Leden I, et al. Chronic pain in a geographically defined general population: studies of differences in age, gender, social class and pain localization. Clin J Pain. 1993;9:174–82. [PubMed] [Google Scholar]

6. Andersson GB. The epidemiology of spinal disorders. In: Frymoyer JW, editor. The adult spine: principles and practice. 2. Philadelphia, PA: Lippincott-Raven; 1997. [Google Scholar]

7. van Tulder MW, Koes BW, Bouter LM. A cost-of-illness study of back pain in The Netherlands. Pain. 1995;62:233–40. doi: 10.1016/0304-3959(94)00272-G. [PubMed] [CrossRef] [Google Scholar]

8. Deyo R, Cherkin D, Conrad D. Cost, controversy, crisis: low back pain and the health of the public. Annu Rev Publ Health. 1991;12:141–56. doi: 10.1146/annurev.pu.12.050191.001041. [PubMed] [CrossRef] [Google Scholar]

9. Bogduk N. The innervation of the lumbar spine. Spine. 1983;8:286–93. doi: 10.1097/00007632-198304000-00009. [PubMed] [CrossRef] [Google Scholar]

10. Williams ME, Hadler NM. The illness as the focus of geriatric medicine. N Engl J Med. 1983;308:1357–60. [PubMed] [Google Scholar]

11. Boden SD, Davis DO, Dina TS, et al. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects: a prospective investigation. J Bone Joint Surg. 1990;72:403–8. [PubMed] [Google Scholar]

12. Wiesel SW, Tsourmas N, Feffer HL, et al. A study of computer-assisted tomography. The incidence of positive CAT scans in an asymptomatic group of patients. Spine. 1984;9:549. doi: 10.1097/00007632-198409000-00003. [PubMed] [CrossRef] [Google Scholar]

13. Pye SR, Reid DM, Lunt M, et al. Lumbar disc degeneration: association between osteophytes, end-plate sclerosis and disc space narrowing. Ann Rheum Dis. 2007;66(3):330–3. doi: 10.1136/ard.2006.052522. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

14. van der Kraan PM, van den Berg WB. Osteophytes: relevance and biology. Osteoarthritis cartilage. 2007;15(3):237–44. doi: 10.1016/j.joca.2006.11.006. [PubMed] [CrossRef] [Google Scholar]

15. Rothschild B. Lumbar spondylosis. In: Emedicine publication. 2008. Available via WebMD. http://emedicine.medscape.com/article/249036-overview.

16. Fardon DF, Milette PC. Nomenclature and classification of lumbar disc pathology. Spine. 2001;26(5):E93–113. doi: 10.1097/00007632-200103010-00006. [PubMed] [CrossRef] [Google Scholar]

17. Schneck CD. The anatomy of lumbar spondylosis. Clin Orthop Relat Res. 1985;193:20–36. [PubMed] [Google Scholar]

18. Gibson JNA, Waddell G. Surgery for degenerative lumbar spondylosis. Spine. 2005;20:2312–20. doi: 10.1097/01.brs.0000182315.88558.9c. [PubMed] [CrossRef] [Google Scholar]

19. Symmons DPM, van Hemert AM, Vandenbrouke JP, et al. A longitudinal study of back pain and radiological changes in the lumbar spines of middle aged women: radiographic findings. Ann Rheum Dis. 1991;50:162–6. doi: 10.1136/ard.50.3.162. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

20. O’Neill TW, McCloskey EV, Kanis JA, et al. The distribution, determinants, and clinical correlates of vertebral osteophytosis: a population based survey. J Rheumatol. 1999;26:842–8. [PubMed] [Google Scholar]

21. Jensen MC, Brant-Zawadzki MN, Obuchowski N, et al. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331(2):69–73. doi: 10.1056/NEJM199407143310201. [PubMed] [CrossRef] [Google Scholar]

22. Frymoyer JW, Newberg A, Pope MH, et al. Spine radiographs in patients with low-back pain. An epidemiological study in men. J Bone Joint Surg Am. 1984;66(7):1048–55. [PubMed] [Google Scholar]

23. Lawrence JS. Disc degeneration. Its frequency and relationship to symptoms. Ann Rheum Dis. 1969;28:121–38. doi: 10.1136/ard.28.2.121. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

24. Kirkaldy-Willis W, Bernard T. Managing low back pain. New York: Churchill livingstone; 1983. [Google Scholar]

25. Boswell MV, Trescot AM, Datta S, et al. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Pain Physician. 2007;10(1):7–111. [PubMed] [Google Scholar]

26. Kirkaldy-Willis WH, Wedge JH, Yong-Hing K, et al. Pathology and pathogenesis of lumbar spondylosis and stenosis. Spine. 1978;3:319–28. doi: 10.1097/00007632-197812000-00004. [PubMed] [CrossRef] [Google Scholar]

27. Menkes CJ, Lane NE. Are osteophytes good or bad? Osteoarthritis Cartilage. 2004;12(Suppl A):S53–4. doi: 10.1016/j.joca.2003.09.003. [PubMed] [CrossRef] [Google Scholar]

28. Peng B, Hou S, Shi Q, et al. Experimental study on mechanism of vertebral osteophyte formation. Chin J Traumatol. 2000;3(4):202–5. [PubMed] [Google Scholar]

29. Blom AB, van Lent PL, Holfhuysen AE, et al. Synovial lining macrophages mediate osteophyte formation during experimental osteoarthritis. Osteoarthritis Cartilage. 2004;12(8):627–35. doi: 10.1016/j.joca.2004.03.003. [PubMed] [CrossRef] [Google Scholar]

30. Snyder DL, Doggett D, Turkelson C. Treatment of degenerative lumbar spinal stenosis. Am Fam Physician. 2004;70(3):517–20. [PubMed] [Google Scholar]

31. Sheldon JT, Sersland T, Leborgne J. Computed tomography of the lower lumbar vertebral column. Radiology. 1977;124:113. [PubMed] [Google Scholar]

32. Williams AL, Haughton VM, Daniels DL, Thornton RS. CT recognition of lateral lumbar disc herniation. Am J Roentgenol. 1982;139(1):345–7. [PubMed] [Google Scholar]

33. Matsumoto M, Chiba K, Nojiri K, Ishikawa M, Toyama Y, Nishikawa Y. Extraforaminal entrapment of the fifth lumbar spinal nerve by osteophytes of the lumbosacral spine: anatomic study and a report of four cases. Spine. 2002;27(6):E169–73. doi: 10.1097/00007632-200203150-00020. [PubMed] [CrossRef] [Google Scholar]

34. MacNab I. Backache. Baltimore: Williams & Wilkins; 1977. [Google Scholar]

35. Hasegawa T, An HS, Haughton VM, et al. Lumbar foraminal stenosis: critical heights of the intervertebral discs and foramina. A cryomicrotome study in cadavera. J Bone Joint Surg Am. 1995;77(1):32–8. [PubMed] [Google Scholar]

36. Buckwalter JA, Saltzman C, Brown T. The impact of osteoarthritis: implications for research. Clin Orthop Relat Res. 2004;427:S6–15. doi: 10.1097/01.blo.0000143938.30681.9d. [PubMed] [CrossRef] [Google Scholar]

37. Heine J, Ûber die Arthritis deformans. Virchows Arch Pathol Anat. 1926;260:521–663. doi: 10.1007/BF01889359. [CrossRef] [Google Scholar]

38. Miller JA, Schmatz C, Schultz AB. Lumbar disc degeneration: correlation with age, sex, and spine level in 600 autopsy specimens. Spine. 1988;13:173–8. doi: 10.1097/00007632-198802000-00008. [PubMed] [CrossRef] [Google Scholar]

39. Boos N, Weissbach S, Rohrbach H, et al. Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science. Spine. 2002;27:2631–44. doi: 10.1097/00007632-200212010-00002. [PubMed] [CrossRef] [Google Scholar]

40. Kramer PA. Prevalence and distribution of spinal osteoarthritis in women. Spine. 2006;31(24):2843–8. doi: 10.1097/01.brs.0000245854.53001.4e. [PubMed] [CrossRef] [Google Scholar]

41. Videman T, Battié MC. Spine update: the influence of occupation on lumbar degeneration. Spine. 1999;24:1164–8. doi: 10.1097/00007632-199906010-00020. [PubMed] [CrossRef] [Google Scholar]

42. Hassett G, Hart DJ, Manek NJ, et al. Risk factors for progression of lumbar spine disc degeneration: the Chingford Study. Arthritis Rheum. 2003;48(11):3112–7. doi: 10.1002/art.11321. [PubMed] [CrossRef] [Google Scholar]

43. Spector TD, MacGregor AJ. Risk factors for osteoarthritis: genetics. Osteoarthritis Cartilage. 2004;12(Suppl A):S39–44. doi: 10.1016/j.joca.2003.09.005. [PubMed] [CrossRef] [Google Scholar]

44. Videman T, Battié MC, Ripatti S, et al. Determinants of the progression in lumbar degeneration: a 5-year follow-up study of adult male monozygotic twins. Spine. 2006;31(6):671–8. doi: 10.1097/01.brs.0000202558.86309.ea. [PubMed] [CrossRef] [Google Scholar]

45. Battié MC, Videman T, Gibbons L, et al. Determinants of lumbar disc degeneration: a study relating lifetime exposures and MRI findings in identical twins. Spine. 1995;20:2601–12. [PubMed] [Google Scholar]

46. Videman T, Leppavuori J, Kaprio J, et al. Intragenic polymorphisms of the vitamin D receptor gene associated with intervertebral disc degeneration. Spine. 1998;23:2477–85. doi: 10.1097/00007632-199812010-00002. [PubMed] [CrossRef] [Google Scholar]

47. Humzah MD, Soames RW. Human intervertebral disc: structure and function [Review] Anat Rec. 1988;220:337–56. doi: 10.1002/ar.1092200402. [PubMed] [CrossRef] [Google Scholar]

48. Lamer TJ. Lumbar spine pain originating from vertebral osteophytes. Reg Anesth Pain Med. 1999;24(4):347–51. [PubMed] [Google Scholar]

49. Hayden JA, van Tulder MW, Malmivaara AV, et al. Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med. 2005;142:765–75. [PubMed] [Google Scholar]

50. Hayden JA, van Tulder MW, Tomlinson G. Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med. 2005;142:776–85. [PubMed] [Google Scholar]

51. Deyo RA, Walsh NE, Martin DC, et al. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N Engl J Med. 1990;322:1627–34. [PubMed] [Google Scholar]

52. Van Tulder MW, Koes B, Malmivaara Outcome of non-invasive treatment modalities on back pain: an evidence-based review. Eur Spine J. 2006;15(1):S64–81. doi: 10.1007/s00586-005-1048-6. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

53. Milne S, Welch V, Brosseau L. Transcutaneous electrical nerve stimulation (TENS) for chronic low back pain. Oxford: The Cochrane Library; 2004. [PubMed] [Google Scholar]

54. Heymans MW, van Tulder MW, Esmail R, et al. Back schools for nonspecific low back pain: a systematic review within the framework of the cochrane collaboration back review group. Spine. 2005;30(19):2153–63. doi: 10.1097/01.brs.0000182227.33627.15. [PubMed] [CrossRef] [Google Scholar]

55. Van der Heijden GJMG, Beurskens AJHM, Dirx MJM, et al. Efficacy of lumbar traction: a randomized clinical trial. Physiotherapy. 1995;81:29–35. doi: 10.1016/S0031-9406(05)67032-0. [CrossRef] [Google Scholar]

56. Borman P, Keskin D, Bodur H. The efficacy of lumbar traction in the management of patients with low back pain. Rheumatol Int. 2003;23:82–6. [PubMed] [Google Scholar]

57. Werners R, Pynsent PB, Bulstrode CJK. Randomized trial comparing interferential therapy with motorized lumbar traction and massage in the management of low back pain in a primary care setting. Spine. 1999;24:1579–84. doi: 10.1097/00007632-199908010-00012. [PubMed] [CrossRef] [Google Scholar]

58. Assendelft WJ, Morton SC, Yu EI, et al. Spinal manipulative therapy for low back pain. A meta-analysis of effectiveness relative to other therapies. Ann Intern Med. 2003;138:871–81. [PubMed] [Google Scholar]

59. Bromfort G, Haas M, Evans RL, et al. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine. 2004;4(3):335–56. doi: 10.1016/j.spinee.2003.06.002. [PubMed] [CrossRef] [Google Scholar]

60. Oliphant D. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment. J Manipulative Physiol Ther. 2004;27:197–210. doi: 10.1016/j.jmpt.2003.12.023. [PubMed] [CrossRef] [Google Scholar]

61. Furlan AD, Brosseau L, Imamura M, et al. Massage for low-back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine. 2002;27(17):1896–910. doi: 10.1097/00007632-200209010-00017. [PubMed] [CrossRef] [Google Scholar]

62. Schnitzer TJ, Ferraro A, Hunsche E, et al. A comprehensive review of clinical trials on the efficacy and safety of drugs for the treatment of low back pain. J Pain Symptom Manage. 2004;28:72–95. doi: 10.1016/j.jpainsymman.2003.10.015. [PubMed] [CrossRef] [Google Scholar]

63. Hickey RF. Chronic low back pain: a comparison of diflunisal with paracetamol. N Z Med J. 1982;95(707):312–4. [PubMed] [Google Scholar]

64. Videman T, Osterman K. Double-blind parallel study of piroxicam versus indomethacin in the treatment of low back pain. Ann Clin Res. 1984;16:156–60. [PubMed] [Google Scholar]

65. Berry H, Bloom B, Hamilton EB, et al. Naproxen sodium, diflunisal, and placebo in the treatment of chronic back pain. Ann Rheum Dis. 1982;41(2):129–32. doi: 10.1136/ard.41.2.129. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

66. DeMoor M, Ooghe R. Clinical trial of oxametacin in low back pain and cervicobrachialgia. Ars Medici Revue Internationale De Therapie Pratique. 1982;37:1509–15. [Google Scholar]

67. Martell BA, O’Connor PG, Kerns RD, et al. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addition. Ann Intern Med. 2007;146(2):116–27. [PubMed] [Google Scholar]

68. Fillingim RB, Doleys DM, Edwards RR, et al. Clinical characteristics of chronic back pain as a function of gender and oral opioid use. Spine. 2003;28:143–50. doi: 10.1097/00007632-200301150-00010. [PubMed] [CrossRef] [Google Scholar]

69. Turk DC, Okifuji A. What factors affect physicians’ decisions to prescribe opioids for chronic noncancer pain patients? Clin J Pain. 1997;13:330–6. doi: 10.1097/00002508-199712000-00011. [PubMed] [CrossRef] [Google Scholar]

70. Salerno SM, Browning R, Jackson JL. The effect of antidepressant treatment in chronic back pain: a meta-analysis. Arch Intern Med. 2002;162:19–24. doi: 10.1001/archinte.162.1.19. [PubMed] [CrossRef] [Google Scholar]

71. Staiger O, Barak G, Sullivan MD, Deyo RA. Systematic review of antidepressants in the treatment of chronic low back pain. Spine. 2003;28:2540–5. doi: 10.1097/01.BRS.0000092372.73527.BA. [PubMed] [CrossRef] [Google Scholar]

72. Salzmann E, Pforringer W, Paal G, et al. Treatment of chronic low-back syndrome with tetrazepam in a placebo controlled double-blind trial. J Drug Dev. 1992;4:219–28. [Google Scholar]

73. Abdi S, Datta S, Trescot AM, et al. Epidural steroids in the management of chronic spinal pain: a systematic review. Pain Physician. 2007;10:185–212. [PubMed] [Google Scholar]

74. Koes BW, Scholten RJ, Mens JM, et al. Efficacy of epidural steroid injections for low-back pain and sciatica: a systematic review of randomized clinical trials. Pain. 1995;63(3):279–88. doi: 10.1016/0304-3959(95)00124-7. [PubMed] [CrossRef] [Google Scholar]

75. Stitz MY, Sommer HM. Accuracy of blind versus fluoroscopically guided caudal epidural injection. Spine. 1999;24(13):1371–6. doi: 10.1097/00007632-199907010-00016. [PubMed] [CrossRef] [Google Scholar]

76. Arden NK, Price C, Reading I, et al. A multicentre randomized controlled trial of epidural corticosteroid injections for sciatica: the WEST study. Rheumatology. 2005;44:1399–406. doi: 10.1093/rheumatology/kei028. [PubMed] [CrossRef] [Google Scholar]

77. Carette S, Leclaire R, Marcoux S, et al. Epidural corticosteroid injections for sciatica due to herniated nucleus pulposus. N Engl J Med. 1997;336:1634–40. doi: 10.1056/NEJM199706053362303. [PubMed] [CrossRef] [Google Scholar]

78. Vad VB, Bhat AL, Lutz GE, et al. Transforaminal epidural steroid injections in lumbosacral radiculopathy: a prospective randomized study. Spine. 2002;27:11–6. doi: 10.1097/00007632-200201010-00005. [PubMed] [CrossRef] [Google Scholar]

79. Lutz GE, Vad VB, Wisneski RJ. Fluoroscopic transforaminal lumbar epidural steroids: an outcome study. Arch Phys Med Rehabil. 1998;79:1362–6. doi: 10.1016/S0003-9993(98)90228-3. [PubMed] [CrossRef] [Google Scholar]

80. Botwin KP, Gruber RD, Bouchlas CG, et al. Fluoroscopically guided lumbar transforaminal epidural steroid injections in degenerative lumbar stenosis: an outcome study. Am J Phys Med Rehabil. 2002;81:898–905. doi: 10.1097/00002060-200212000-00003. [PubMed] [CrossRef] [Google Scholar]

81. Riew KD, Park JB, Cho YS, et al. Nerve root blocks in the treatment of lumbar radicular pain: a minimum 5-year follow up. J Bone Joint Surg Am. 2006;88:1722–5. doi: 10.2106/JBJS.E.00278. [PubMed] [CrossRef] [Google Scholar]

82. Riew KD, Yin Y, Gilula L, Bridwell, et al. The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain. J Bone Joint Surg Am. 2000;82:1589–93. [PubMed] [Google Scholar]

83. Yang SC, Fu TS, Lai PL, et al. Transforaminal epidural steroid injection for discectomy candidates: an outcome study with a minimum of 2 year follow-up. Chang Gung Med J. 2006;29:93–9. [PubMed] [Google Scholar]

84. Boswell MV, Singh V, Staats PS, et al. Accuracy of precision diagnostic blocks in the diagnosis of chronic spinal pain of facet or zygapophysial joint origin: a systematic review. Pain Physician. 2003;6:449–56. [PubMed] [Google Scholar]

85. Sehgal N, Dunbar EE, Shah RV, et al. Systematic review of diagnostic utility of facet (zygapophysial) joint injections in chronic spinal pain: an update. Pain Physician. 2007;10(1):213–28. [PubMed] [Google Scholar]

86. Boswell MV, Colson JD, Sehgal N, et al. A systematic review of therapeutic facet joint interventions in chronic spinal pain. Pain Physician. 2007;10:229–53. [PubMed] [Google Scholar]

87. Fuchs S, Erbe T, Fischer HL, et al. Intraarticular hyaluronic acid versus glucocorticoid injections for nonradicular pain in the lumbar spine. J Vasc Interv Radiol. 2005;16:1493–8. [PubMed] [Google Scholar]

88. Carette S, Marcoux S, Truchon R, et al. A controlled trial of corticosteroid injections into facet joints for chronic low back pain. N Engl J Med. 1991;325:1002–7. [PubMed] [Google Scholar]

89. Manchikanti L, Pampati VS, Bakhit C, et al. Effectiveness of lumbar facet joint nerve blocks in chronic low back pain: a randomized clinical trial. Pain Physician. 2001;4:101–17. [PubMed] [Google Scholar]

90. Pereira PL, Gunaydin I, Trubenbach J, et al. Interventional MR imaging for injection of sacroiliac joints in patients with sacroiliitis. Am J Roentgenol. 2000;175:265–6. [PubMed] [Google Scholar]

91. Maugars Y, Mathis C, Berthelot JM, et al. Assessment of the efficacy of sacroiliac corticosteroid injections in spondylarthropathies: a double-blind study. Br J Rheumatol. 1996;35(8):767–70. doi: 10.1093/rheumatology/35.8.767. [PubMed] [CrossRef] [Google Scholar]

92. Hansen HC, McKenzie-Brown AM, Cohen SP, et al. Sacroiliac joint interventions: a systematic review pain physician. 2007;10(1):165–84. [PubMed] [Google Scholar]

93. Wichman HJ. Discography: over 50 years of controversy. WMJ. 2007;106(1):27–9. [PubMed] [Google Scholar]

94. Katz JN, Lipson SJ, Chang LC, et al. Seven to ten year outcome of decompressive surgery for degenerative lumbar spinal stenosis. Spine. 1996;21:92. doi: 10.1097/00007632-199601010-00022. [PubMed] [CrossRef] [Google Scholar]

95. Ibrahim T, Tleyjeh IM, Gabbar O. Surgical versus non-surgical treatment of chronic low back pain: a meta-analysis of randomized trials. In: International orthopedics. Available via SpringerLink. 2006. http://www.springerlink.com/content/b9634hh822764233/. Accessed 21 Nov 2006.

404 Page not found

We use cookies to improve the MSTU website and make it easier to use. More information on the use of cookies can be found here.
By continuing to use the site, you confirm that you have been informed about the use of cookies by the FGBOU VO “MSTU” site and agree to our rules for processing personal data.

Size:

AAA

Images

On
Off

Regular version of the site

Unfortunately, the requested page was not found.

But you can use the search or the sitemap below

  • University

    Maikop State Technological University is one of the leading universities in the south of Russia.

    • University history
    • Announcements
    • Advertisements
    • Media
      • Media Representatives
      • Newspaper “Tekhnolog”
      • Write about us
    • Rectorate
    • Structure
      • Branch
      • Polytechnic College
      • Medical Institute
        • Faculty of Medicine
        • Faculty of Pediatrics
        • Faculty of Pharmacy
        • Faculty of Dentistry
        • Faculty of Postgraduate Professional Education
      • Faculties
      • Chairs
    • Academic Council
    • Lean University – MSTU
      • News
      • Advertisements
      • Problem sheet
      • Proposal Sheet (Kaizen)
      • Projects in progress
      • Project archive
      • Process Factory
      • Working group “Lean University-MSTU”
    • Vacancies
    • Trade union
    • Countering terrorism and extremism
    • Additional professional education
    • Anti-corruption
    • WorldSkills at MSTU
    • Research Library of MSTU
    • Requisites and contacts
    • Driving School MSTU
    • Survey to identify citizens’ opinions on the quality of conditions for the provision of educational services
    • Property complex MSTU
    • MSTU work in the context of preventing COVID-19
    • University Quality Management System
    • Regional Center for Financial Literacy
    • Accreditation and Simulation Center
    • Documents regulating educational activities
  • Applicants
    • Apply online
    • Applicants 2023
      • For applicants for undergraduate, specialist, master’s programs – Admission 2023
      • For applicants for secondary vocational education programs (college)
      • For applicants for training under contracts for the provision of paid educational services
        • Sample contract
        • Educational loan
        • Payment by maternity (family) capital
        • Bank details for paying for tuition
        • Order on the establishment of tuition fees for the 1st course of enrollment of the 2022-2023 academic year
      • For applicants for residency programs
      • Applicants for PhD programs
      • Frequently Asked Questions (bachelor’s, specialist’s, master’s)
      • Video materials for applicants
      • Reception screen 2023
    • Reception screen 2023
    • Foreign applicants
      • International activities
      • General
      • Chairs
      • News
      • International Education Center
      • Academic mobility and international cooperation
        • Academic mobility and funds
        • Individual mobility of students and graduate students
        • How to become a member of academic mobility programs
    • Open days at MSTU
      • Open days online
      • University Saturdays
      • Open days at faculties
    • Small Technological Academy
      • Profile class
        • Social and economic profile
        • Medical pharmaceutical profile
        • Engineering profile
        • Eco-biological profile
        • Agrotech profile
      • Custom project
      • Circle movement of young technologists
      • Olympics, competitions, festivals
    • Preparatory courses
      • Preparatory department
      • Courses for graduates of SVE
      • Preparation courses for passing the OGE and USE
      • Online Exam Preparation Courses
      • Preparing schoolchildren for participation in Olympiads
    • School Olympiad
      • Qualifying round
      • Final stage
      • Results of the Olympiads
    • Career guidance
    • Tuition fees
    • Web-based consultations for applicants and their parents
      • Web-based consultations for applicants
      • Parent University
  • Students
    • Student life
      • Scholarships
      • Organization of research and development work at MSTU
      • Student Scientific Society
      • Student scientific activities
      • Competitions
      • Academic mobility and international cooperation
    • Educational programs
    • Schedule
    • Bell schedule
    • Online Services
    • Social support for students
    • Dormitories
    • Employment of students and graduates
      • Vacancies
    • Software security
    • Inclusive education
      • Learning environment for people with disabilities
      • Accessible Environment
    • MSTU Alumni Association
    • Transfer from another university
    • Vacancies for translation
    • Student Space
      • Student space
      • Registration for events
    • Department for social and educational work
  • Science and innovation
    • Science infrastructure
      • Vice-Rector for Research and Innovative Development
      • Scientific and technical council
      • Scientific management
      • Office of Postgraduate Education
      • Boiling point MSTU
        • Boiling point MSTU
        • Manager and staff
        • Documents
        • Contacts
      • Shared Use Center
      • Center for Public Diplomacy and Intercultural Communications
      • Student Scientific Society
    • Scientific publications
      • Scientific journal “New Technologies”
      • Scientific journal “Vestnik MSTU”
      • Scientific journal “Actual issues of science and education”
    • Publication activity
    • Competitions, grants
    • Scientific directions and results of research activities
      • Main scientific directions of the university
      • University Research Report
      • The effectiveness of research and development MSTU
      • Funded research work
      • Objects of intellectual property MSTU
      • The effectiveness of scientific activities of organizations subordinate to the Ministry of Education and Science of Russia (Questionnaires for reference groups)
    • Student Scientific Society
    • Innovation infrastructure
      • Federal innovation site
      • Problem research laboratories
        • Research laboratory “Improvement of the regional economy management system”
        • Research Laboratory for Problems of Development of the Regional Economy
        • Research Laboratory of Organization and Technology of Information Security
        • Research Laboratory of Functional Diagnostics (NILFD) of the Medical Faculty of the Medical Institute of the FGBOU VPO “MSTU”
        • Research laboratory “Innovative projects and nanotechnologies”
      • Scientific, technical and experimental base
      • Shared Use Center
      • Scientific Library
    • Export control
    • Local ethics committee
    • Conferences
      • Young Doctor School
      • International scientific and practical conference “Fundamental and applied aspects of geology, geophysics and geoecology using modern information technologies”
      • International Scientific and Practical Conference “Actual Issues of Science and Education”
      • VI International Scientific and Practical Online Conference
    • Science and universities
  • International activities
    • International students
    • International partners
    • Academic exchanges, foreign teachers
      • Academic mobility and funds
      • Individual mobility of students and graduate students
    • Faculty of International Education
      • Faculty News
      • Faculty information
      • International activities
      • Departments
        • Department of Russian as a foreign language
        • Department of Foreign Languages ​​
      • International Education Center
      • Russian language training center for foreign citizens
        • Orders and instructions
        • Russian language courses
        • Schedule
      • Academic mobility
      • Contact information
    • Contact information of the Faculty of International Education
  • Information about the educational organization
    • Basic information
    • Structure and governing bodies of an educational organization
    • Documents
    • Education
    • Educational standards and requirements
    • Manual. Pedagogical (scientific and pedagogical) staff
    • Logistics and equipment of the educational process
    • Scholarships and student support measures
    • Paid educational services
    • Financial and economic activities
    • Vacancies for reception (transfer)
    • International cooperation
    • Accessible environment
    • Catering in an educational organization

Potential for the use of hydroxyapatite-based bone substitute materials in spinal surgery | Mukhametov

1. Fink B., Schlumberger M. Antibiotic therapy alone does not have a high success rate in cases of unexpected positive cultures in intraoperative samples from hip and knee prosthesis revision. BMC Musculoskelet Disord. 2020;21(1):786. DOI: 10.1186/s12891-020-03799-w

2. Maji K., Dasgupta S. Hydroxyapatite-chitosan and gelatin based scaffold for bone tissue engineering. Transactions of the Indian Ceramic Society. 2014;73:110–4. DOI: 10.1080/0371750X.2014.922424

3. Sharma C., Dinda A.K., Potdar P.D., Chou C.F., Mishra N.C. Fabrication and characterization of novel nano-biocomposite scaffold of chitosan-gelatin-alginate-hydroxyapatite for bone tissue engineering. Mater Sci Eng C Mater Biol Appl. 2016;64:416–27. DOI: 10.1016/j.msec.2016.03.060

4. Maji K., Dasgupta S. Characterization and in vitro evaluation of gelatin-chitosan scaffold reinforced with bioceramic nanoparticles for bone tissue engineering. J Mat Res. 2019;34(16):2807–18. DOI: 10.1557/jmr.2019.170

5. Hinsenkamp M., Muylle L., Eastlund T., Fehily D., Noel L., Strong D.M. Adverse reactions and events related to musculoskeletal allografts: reviewed by the World Health Organization Project NOTIFY. Int Orthop. 2012;36(3):633–41. DOI: 10.1007/s00264-011-1391-7

6. Coraça-Huber D.C., Nogler M., Kühn K.D. Potential of allogeneic bone grafts as antibiotic carriers: Effect of different preparation processes on efficacy. Orthopade. 2018;47(1):30–8. DOI: 10.1007/s00132-017-3507-2

7. Ebrahimi M., Botelho M., Lu W. Synthesis and characterization of biomimetic bioceramic nanoparticles with optimized physicochemical properties for bone tissue engineering. J Biomed Mat Res. 2019;107:1654–66. DOI: 10.1002/jbm.a.36681

8. Mansor A., ​​Ariffin A.F., Yusof N., Mohd S., Ramalingam S., Md Saad A.P., et al. Effects of processing and gamma radiation on mechanical properties and organic composition of frozen, freeze-dried and demineralised human cortical bone allograft. Cell Tissue Bank. 2022 May 25. DOI: 10.1007/s10561-022-10013-9

9. Elhendawi H., Felfel R.M., Bothaina M., Abd El-Hady, Reicha F.M. Effect of synthesis temperature on the crystallization and growth of in situ prepared nanohydroxyapatite in chitosan matrix. ISRN Biomaterials. 2014;5:1–8. DOI: 10.1155/2014/897468

10. Buchholz H.W., Engelbrecht H. Depot effects of various antibiotics mixed with Palacos resins. Chirug. 1970;41(11):511–5. PMID: 5487941

11. Lindsey R.W., Probe R., Miclau T., Alexander J.W., Perren S.M. The effects of antibiotic-impregnated autogeneic cancellous bone grafton bone healing. Clin Orthop Relat Res. 1993;291:303–12. DOI: 10.1097/00003086-199306000-00035

12. Goldberg V.M. Selection of bone grafts for revision total hip arthroplasty. Clin Orthop Relat Res. 2000;381:68–76. 13. Barckman J., Baas J., Sorensen M., Lange J., Bechtold J.E., Soballe K. Does tobramycin impregnation of allograft bone affect implant fixation?—an experimental study in 12 dogs. J Biomed Mater Res Part B Appl Biomater. 2014;102(1):173–80. DOI: 10.1002/jbm.b.32993

14. Prokes L., Snejdrova E., Soukup T., Malakova J., Frolov V., Loskot J., et al. Allogeneic bone impregnated with biodegradable depot delivery systems for the local treatment of joint replacement infections: an in vitro study. Molecules. 2022;27(19):6487. DOI: 10.3390/molecules27196487

15. Ishiguro S., Asanuma K., Tamaki T., Oinuma K., Sudo A. A case of cementless impaction bone graft in a revision total hip arthroplasty requiring calcar reconstruction. Case Rep Orthop. 2021;2021:8811593. DOI: 10.1155/2021/8811593

16. Chou P.H., Lin H.H., Yao Y.C., Chang M.C., Liu C.L., Wang S.T. Does local vancomycin powder impregnated with autogenous bone graft and bone substitute decrease the risk of deep surgical site infection in degenerative lumbar spine fusion surgery?-An ambispective study. BMC Musculoskelet Disord. 2022;23(1):853. DOI: 10.1186/s12891-022-05802-y

17. Xu H., Yang J., Xie J., Huang Z., Huang Q., Cao G., et al. Efficacy and safety of intrawound vancomycin in primary hip and knee arthroplasty. Bone Joint Res. 2020;9(11):778–88. DOI: 10.1302/2046-3758.911.BJR-2020-0190.R2

18. Erivan R., Lopez-Chicon P., Fariñas O., Perez Prieto D., Grau S., Boisgard S., et al. Which type of bone releases the most vancomycin? Comparison of spongious bone, cortical powder and cortico-spongious bone. Cell Tissue Bank. 2020;21(1):131–7. DOI: 10.1007/s10561-019-09806-2

19. Bullens P.H., Minderhoud N.M., de Waal Malefijt M.C., Veth R.P., Buma P., Schreuder H.W. Survival of massive allografts in segmental oncological bone defects reconstructions. Int Orthop. 2009;33(3):757–60. DOI: 10.1007/s00264-008-0700-2

20. Zuh S.G., Zazgyva A., Gergely I., Pop T.S. Acetabuloplasty with bone grafting in uncemented hip replacement for protrusion. Int Orthop. 2015;39(9):1757–63. DOI: 10.1007/s00264-015-2804-9

21. Wilson M.J., Hook S., Whitehouse S.L., Timperley A.J., Gie G.A. Femoral impaction bone grafting in revision hip arthroplasty: 705 cases from the originating centre. Bone Joint J. 2016;98-B(12):1611–9. DOI: 10.1302/0301-620X.98B12.37414

22. Frommelt L. Indication für die zugabe von antibiotika. In: Jerosch J., Katthagen B.D., Pruß A. (Hrsg) Knochentransplantation. 2012;S151–4.

23. Kühn K.D., Höntzsch D. Augmentation with PMMA cement. Unfallchirg. 2015;118(9):737–48. DOI: 10.1007/s00113-015-0059-y

24. Wekwejt M., Michalska-Sionkowska M., Bartmański M., Nadolska M., Łukowicz K., Pałubicka A., et al. Influence of several biodegradable components added to pure and nanosilver-doped PMMA bone cements on its biological and mechanical properties. Mater Sci Eng C Mater Biol Appl. 2020;117:111286. DOI: 10.1016/j.msec.2020.111286

25. Götte S. Osteologie – 100 Jahre. Orthopade. 2001;30:805–11.

26. Zhao R., Yang R., Cooper P.R., Khurshid Z., Shavandi A., Ratnayake J. Bone grafts and substitutes in dentistry: a review of current trends and developments. Molecules. 2021;26(10):3007. DOI: 10.3390/molecules26103007

Clin Implant Dent Relat Res. 2021;23(4):506–19. DOI: 10.1111/cid.13014

28. Rueger J.M. Bone substitutes. State of the art and: what lies ahead? Unfallchirg. 1996;99(3):228–36. PMID: 8685730

29. Soldner E., Herr G. Knochen, Knochentransplantate und Knochenersatzmaterialien. Trauma Berufskr. 2001;3:256–69. DOI: 10.1007/s10039-001-0503-9

30. Ferguson J., Diefenbach M., McNally M. Ceramic biocomposites as biodegradable antibiotic carriers in treatment of bone infection. J Bone Jt Infect. 2017;2(1):38–49. DOI: 10.7150/jbji.17234

31. Hettwer W. Synthetischer Knochenersatz. Orthopade. 2017;46:688–700. DOI: 10.1007/s00132-017-3447-x

32. Roberts T.T., Rosenbaum A.J. Bone grafts, bone substitutes and orthobiologics: the bridge between basic science and clinical advancements in fracture healing. Organogenesis. 2012;8(4):114–24. DOI: 10.4161/org.23306

33. Ochsner P.E., Borens O., Bodler P.M., Broger I., Eich G., Maurer T., et al. Infection des Bewegungsapparates. Grandvaux: Eigenverlag swiss orthopaedics; 2014.

34. Khan S.N., Tomin E., Lane J.M. Clinical applications of bone graft substitutes. Orthop Clin North Am. 2000;31(3):389–98. DOI: 10.1016/s0030-5898(05)70158-9

35. Allison D.C., Lindberg A.W., Samimi B., Mirzayan R., Menendez L.R. A comparison of mineral bone graft substitutes for bone defects. US Oncol Hematol. 2011;7(1):38–49. DOI: 10.17925/OHR.2011.07.1.38

In: Peters K., König D. (Hrsg) Fortbildung Osteologie. Berlin: Springer; 2010. Deutsch.

37. van Vugt T.A., Geurts J.A.P., Arts J.J., Lindforts N.C. Biomaterials in the treatment of orthopedic infections. In: Arts J.J., Geurts J.A.P. (eds) Management of periprosthetic joint infections (PJIs). Swaston: Woodhead Publ.; 2016.

38. Boot W., Vogely H.C. Prophylaxis for implant related infections: current state of the art. In: Kühn (ed) Management of periprosthetic joint infection. Heidelberg: Springer; 2018.

39. Enax J., Janus A.M., Raabe D., Epple M., Fabritius H.O. Ultrastructu – ral organization and micromechanical properties of shark tooth enameloid. Acta Biomater. 2014;10:3959–68. DOI: 10.1016/j.actbio.2014.04.028

40. Schnürer S.M., Gopp U., Kühn K.D., Breusch S.J. Knochenersatzwerkstoffe. Orthopade. 2003;32:2–10. Deutsch. DOI: 10.1007/s00132-002-0407-9

41. Zhang E., Zhang W. , Lv T., Li J., Dai J., Zhang F., et al. Insulating and robust ceramic nanorod aerogels with high temperature resistance over 1400 C. ACS Appl Mater Interfaces. 2021;13(17):20548–58. DOI: 10.1021/acsami.1c02501

42. Barbeck M., Jung O., Smeets R., Gosau M., Schnettler R., Rider P., et al. Implantation of an injectable bone substitute material enables integration following the principles of guided bone regeneration. in vivo. 2020;34(2):557–68. DOI: 10.21873/invivo.11808

43. Chen J., Ashames A., Buabeid M.A., Fahelelbom K.M., Ijaz M., Murtaza G. Nanocomposites drug delivery systems for the healing of bone fractures. Int J Pharm. 2020;585:119477. DOI: 10.1016/j.ijpharm.2020.119477

44. Fernandez de Grado G., Keller L., Idoux-Gillet Y., Wagner Q., Musset A.M., Benkirane-Jessel N., et al. Bone substitutes: a review of their characteristics, clinical use, and perspectives for large bone defects management. J Tissue Eng. 2018;9:2041731418776819. DOI: 10.1177/2041731418776819

45. He Q., Chen H., Huang L., Dong J., Guo D., Mao M., et al. Porous surface modified bioactive bone cement for enhanced bone bonding. PLoS One 2012;7(8):e42525. DOI: 10.1371/journal.pone.0042525

46. Chen C.-C., Wang C.-W., Hsueh N.-S., Ding S.-J. Improvement of in vitro physicochemical properties and osteogenic activity of calcium sulfate cement for bone repair by dicalcium silicate. J Alloys Compd. 2014;585:25–31. DOI: 10.1016/j.jallcom.2013.09.138

47. Shirtliff M.E., Mader J.T., Camper A.K. Molecular interaction in biofilms. Chem Biol. 2002;9(8):859–71.

48. Korkusuz F., Uchida A., Shinto Y., Araki N., Inoue K., Ono K. Experimental implant-related osteomyelitis treated by antibioticcalcium hydroxyapatite ceramic composites. J Bone Joint Surg Br. 1993;75(1):111–4. DOI: 10.1302/0301-620X.75B1.8380599

49. Rauschmann M.A., Wichelhaus T.A., Stirnal V., Dingeldein E., Zichner L., Schnettler R., et al. Nanocrystalline hydroxyapatite and calcium sulphate as biodegradable composite carrier material for local delivery of antibiotics in bone infections. biomaterials. 2005;26(15):2677–84. DOI: 10.1016/j.biomaterials.2004.06.045

50. Romano C.L., Logoluso N., Meani E., Romano D., De Vecchi E., Vassena C., et al. A comparative study of the use of bioactive glass S53P4 and antibiotic-loaded calcium-based bone substitutes in the treatment of chronic osteomyelitis. Bone Joint J. 2014;96(6):845–50. DOI: 10.1302/0301-620X.96B6.33014

51. Fosca M., Rau J.V., Uskoković V. Factors influencing the drug release from calcium phosphate cements. Bioact Mater. 2021;7:341–63. DOI: 10.1016/j.bioactmat.2021.05.032

52. Usai P., Campanella V., Sotgiu G., Spano G., Pinna R., Eramo S., et al. Effectiveness of calcium phosphate desensitising agents in dental hypersensitivity over 24 weeks of clinical evaluation. Nanomaterials (Basel). 2019;9(12):1748. DOI: 10.3390/nano9121748

53. Kurien T., Pearson R.G., Scammell B.E. Bone graft substitutes current lyavailable inorthopaedic practice the evidence for their use. Bone Joint J. 2013;95(5):583–97.