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ABSTRACT: Study design
Guideline.Objectives
To develop an international guideline (AOGO) about the use of osteobiologics in anterior cervical discectomy and fusion (ACDF) for treating degenerative spine conditions.Methods
The guideline development process was guided by AO Spine Knowledge Forum Degenerative (KF Degen) and followed the Guideline International Network McMaster Guideline Development Checklist. The process involved 73 participants with expertise in degenerative spine diseases and surgery from 22 countries. Fifteen systematic reviews were conducted addressing respective key topics and evidence was collected. The methodologist compiled the evidence into GRADE Evidence-to-Decision frameworks. Guideline panel members judged the outcomes and other criteria and made the final recommendations through consensus.Results
Five conditional recommendations were created. A conditional recommendation is about the use of allograft, autograft or a cage with an osteobiologic in primary ACDF surgery. Other conditional recommendations are about the use of osteobiologic for single- or multi-level ACDF, and for hybrid construct surgery. It is suggested that surgeons use other osteobiologics rather than human bone morphogenetic protein-2 (BMP-2) in common clinical situations. Surgeons are recommended to choose 1 graft over another or 1 osteobiologic over another primarily based on clinical situation, and the costs and availability of the materials.Conclusion
This AOGO guideline is the first to provide recommendations for the use of osteobiologics in ACDF. Despite the comprehensive searches for evidence, there were few studies completed with small sample sizes and primarily as case series with inherent risks of bias. Therefore, high-quality clinical evidence is demanded to improve the guideline.
SUBMITTER: Meisel HJ
PROVIDER: S-EPMC10913909 | biostudies-literature | 2024 Feb
REPOSITORIES: biostudies-literature
Meisel Hans Jörg HJ Jain Amit A Wu Yabin Y Martin Christopher T CT Cabrera Juan Pablo JP Muthu Sathish S Hamouda Waeel O WO Rodrigues-Pinto Ricardo R Arts Jacobus J JJ Viswanadha Arun-Kumar AK Vadalà Gianluca G Vergroesen Pieter-Paul A PA Ćorluka Stipe S Hsieh Patrick C PC Demetriades Andreas K AK Watanabe Kota K Shin John H JH Riew K Daniel KD Papavero Luca L Liu Gabriel G Luo Zhuojing Z Ahuja Sashin S Fekete Tamás T Uz Zaman Atiq A El-Sharkawi Mohammad M Sakai Daisuke D Cho Samuel K SK Wang Jeffrey C JC Yoon Tim T Santesso Nancy N Buser Zorica Z
Global spine journal 20240201 2_suppl
<h4>Study design</h4>Guideline.<h4>Objectives</h4>To develop an international guideline (AOGO) about the use of osteobiologics in anterior cervical discectomy and fusion (ACDF) for treating degenerative spine conditions.<h4>Methods</h4>The guideline development process was guided by AO Spine Knowledge Forum Degenerative (KF Degen) and followed the Guideline International Network McMaster Guideline Development Checklist. The process involved 73 participants with expertise in degenerative spine di ...[more]