Bone union rate with autologous iliac bone versus local bone graft in posterior lumbar interbody fusion (PLIF): a multicenter study

Abstract

Purpose The purpose of this study is to compare bone union rate between autologous iliac bone and local bone graft in patients treated by posterior lumbar interbody fusion (PLIF) using carbon cage for single level interbody fusion. Methods The subjects were 106 patients whose course could be observed for at least 2 years. The diagnosis was lumbar spinal canal stenosis in 46 patients, herniated lumbar disk in 12 patients and degenerative spondylolisthesis in 51 patients. Single interbody PLIF was done using iliac bone graft in 53 patients and local bone graft in 56 patients. Existence of pseudo-arthrosis on X-P (AP and lateral view) was investigated during the same follow up period.Results No significant differences were found in operation time and blood loss. Significant differences were also not observed in fusion grade at any follow up period or in fusion progression between the two groups. Donor site pain continued for more than 3 months in five cases (9 %). The final fusion rate was 96.3 versus 98.3 %. Conclusions Almost the same results in fusion were obtained from both the local bone group and the autologous iliac bone group. Fusion progression was almost the same. Complications at donor sites were seen in 19 % of the cases. From the above results, it was concluded that local bone graft is as beneficial as autologous iliac bone graft for PLIF at a single level.

Comparative study of 1‐year clinical and radiological outcomes using robot‐assisted pedicle screw fixation and freehand technique in posterior lumbar interbody fusion: A prospective, randomized controlled trial

“…First, fusion status was graded using CT at 1 year after surgery according to the Brantigan, Steffee, Fraser (BSF) classification . Second, fusion status was also determined by flexion/extension x‐rays, in which fusion was defined as <5° difference in Cobb angles according to previous studies . These radiological assessments were performed separately by 2 independent observers, who were each blinded to the purpose of the study, the patient's clinical information and the other observer's assessment.…”

Lumbar interbody fusion with porous biphasic calcium phosphate enhanced by recombinant bone morphogenetic protein-2/silk fibroin sustained-released microsphere: an experimental study on sheep model

“…Lumbar interbody fusion is an effective treatment for patients with symptomatic degenerative disc diseases such as lumbar canal stenosis, spondylolithesis and disc protrusion associated with instability [1][2][3]. Direct removal of the degenerated disc creates a space for grafting and new bone formation, thereby improving the chances of fusion.…”

Hybrid Biosynthetic Autograft Extender for Use in Posterior Lumbar Interbody Fusion: Safety and Clinical Effectiveness

“…While autologous iliac crest bone is recognized as the most successful grafting material due to its osteoconductive, osteogenic and osteoinductive properties [1,2], complication rates of this invasive procedure remain high [3][4][5], with protracted postoperative pain at the donor site being the most commonly reported complication [6]. In an attempt to limit such complications by either reducing or eliminating iliac crest autograft harvest, demineralized bone matrix (DBM) and synthetic osteoconductive bone graft extenders (BGEs) are often used in spinal fusion procedures as an adjunct to patient-derived autograft [7][8][9][10][11].…”

“…In an attempt to limit such complications by either reducing or eliminating iliac crest autograft harvest, demineralized bone matrix (DBM) and synthetic osteoconductive bone graft extenders (BGEs) are often used in spinal fusion procedures as an adjunct to patient-derived autograft [7][8][9][10][11]. Similarly, local bone may be used in lieu of iliac crest grafts, although current evidence suggests that while local bone is equally effective as iliac crest bone in single-level fusion [6,12], it has been associated with significantly lower fusion rates when utilized in multi-level fusion due to volume limitations [1].…”