Outcome of Local Bone Versus Autogenous Iliac Crest Bone Graft in the Instrumented Posterolateral Fusion of the Lumbar Spine

Sengupta, Dilip K.; Truumees, Eeric; Patel, Chetan K.; Kazmierczak, Chris D.; Hughes, Brian; Elders, Greg; Herkowitz, Harry N.

doi:10.1097/01.brs.0000215048.51237.3c

Cited by 136 publications

(119 citation statements)

References 14 publications

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“…There has been one report comparing the clinical and radiologic outcome of instrumented posterolateral lumbar fusion using local bone versus an autogenous ICBG using a retrospective comparative study [9]. Overall fusion rate was higher in the ICBG group (75%) compared with the local bone graft group (65%), but not significantly different [9]. In the current prospective randomized study, fusion rate using local bone graft and ICBG was consistent with the previous studies.…”

Section: Discussionsupporting

confidence: 84%

“…Prospective studies evaluating fusion rate using instrumented posterolateral fusion with ICBG showed results from 82 to 95% [2,12]. There has been one report comparing the clinical and radiologic outcome of instrumented posterolateral lumbar fusion using local bone versus an autogenous ICBG using a retrospective comparative study [9]. Overall fusion rate was higher in the ICBG group (75%) compared with the local bone graft group (65%), but not significantly different [9].…”

Section: Discussionmentioning

confidence: 99%

“…There was no significant difference in single-level fusion rate and overall clinical outcome between the two groups [9]. The investigators concluded that local bone graft alone achieved a similar clinical outcome, but with less morbidity irrespective of number of fusion levels [9]. However, there has been no study using a prospective randomized method.…”

Section: Introductionmentioning

confidence: 97%

“…Successful fusion mass was radiographically confirmed in 93% of patients at the arthrodesis level [6]. Clinical and radiologic outcome of instrumented posterolateral lumbar fusion using local bone versus autogenous ICBG have been evaluated retrospectively [9]. There was no significant difference in single-level fusion rate and overall clinical outcome between the two groups [9].…”

Section: Introductionmentioning

confidence: 98%

“…Clinical and radiologic outcome of instrumented posterolateral lumbar fusion using local bone versus autogenous ICBG have been evaluated retrospectively [9]. There was no significant difference in single-level fusion rate and overall clinical outcome between the two groups [9]. The investigators concluded that local bone graft alone achieved a similar clinical outcome, but with less morbidity irrespective of number of fusion levels [9].…”

Section: Introductionmentioning

confidence: 99%

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Single-level instrumented posterolateral fusion of the lumbar spine with a local bone graft versus an iliac crest bone graft: a prospective, randomized study with a 2-year follow-up

et al. 2010

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The iliac crest bone grafting (ICBG) technique for lumbar posterolateral fusion surgery is widely used; however, donor site problems such as pain and sensory disturbance have been reported. Local bone is available for fusion surgery, but its reliability as a graft has not been fully reported. In the current study, we examined singlelevel instrumented posterolateral fusion with a local bone graft versus an ICBG in a prospective randomized study. Eighty-two patients diagnosed with L4 degenerated spondylolisthesis were divided into two groups at random. Forty-two patients underwent instrumented posterolateral fusion with a local bone graft (L4-L5 level), and 40 patients underwent instrumented posterolateral fusion with an ICBG (L4-L5 level). Rate and duration of bone union, visual analog scale (VAS) score, Japanese orthopedic association score (JOAS), Oswestry Disability Index (ODI), and complications were evaluated before and 2 years after therapy. VAS score, JOAS, and ODI were not significantly different between the two groups before and after surgery (P [ 0.05). Rate and average duration of bone union were 90% and 8.5 months in the local bone graft group, and 85% and 7.7 months in the ICBG group, but without significant difference (P [ 0.05). Prolonged surgical time and complications such as donor site pain (8 patients) and sensory disturbance (6 patients) were observed in the ICBG group. If single-level posterolateral fusion was performed, local bone graft technique has the same bone union rate compared with ICBG, requires less surgical time, and has fewer complications.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Single-level instrumented posterolateral fusion of the lumbar spine with a local bone graft versus an iliac crest bone graft: a prospective, randomized study with a 2-year follow-up

et al. 2010

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Surgical options for lumbar spinal stenosis

Machado

Ferreira

Yoo

et al. 2016

Cochrane Database of Systematic Reviews

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The most common reason for spinal surgery in elderly patients is lumbar spinal stenosis (LSS). For LSS, treatment decisions based on clinical and radiological information as well as personal experience of the surgeon shows large variance. Thus a standardized support system is of high value for a more objective and reproducible decision. In this work, we develop an automated algorithm to localize the stenosis causing the symptoms of the patient in magnetic resonance imaging (MRI). With 22 MRI features of each of five spinal levels of 321 patients, we show it is possible to predict the location of lesion triggering the symptoms. To support this hypothesis, we conduct an automated analysis of labeled and unlabeled MRI scans extracted from 788 patients. We confirm quantitatively the importance of radiological information and provide an algorithmic pipeline for working with raw MRI scans.

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Platelet leukocyte gel facilitates bone substitute growth and autologous bone growth in a goat model

Everts

Delawi

Mahoney

et al. 2009

J Biomedical Materials Res

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The aim of this study is to evaluate multiple conditions on the formation of bone growth in a goat model. We prepared from a unit of whole blood, platelet-leukocyte gel (PLG) to stimulate bone formation, based on the release of platelet growth factors. Two 3-compartment cages containing autologous bone, calcium phosphate, and trabecular metal were implanted onto goat spinal transverse processes. One cage was treated with PLG, prepared according to a standardized protocol. An untreated cage served as a control. To monitor bone formation overtime, fluorochrome markers were administered at 2, 3, and 5 weeks. Animals were sacrificed at 9 weeks after implantation. Bone growth in these 3-compartments cages was examined by histology and histomorphometry of nondecalcified sections using traditional light and epifluorescent microscopy. Compared to the control samples, bone growth in the PLG-treated autologous bone and calcium phosphate samples was significantly more. Fairly little bone growth was seen in PLG treated or untreated trabecular metal scaffolds. The results obtained from this goat model suggest a potential role for the application of autologous PLG during surgeries in which autologous bone grafts or calcium phosphate scaffolds are used.

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Outcome of Local Bone Versus Autogenous Iliac Crest Bone Graft in the Instrumented Posterolateral Fusion of the Lumbar Spine

Abstract: Use of local bone graft alone achieved a similar fusion rate in single-level fusion but a much smaller fusion rate in multilevel fusion compared with the ICBG group. Local bone graft alone achieved a similar clinical outcome but less morbidity irrespective of number of fusion level.

Cited by 136 publications

References 14 publications

Single-level instrumented posterolateral fusion of the lumbar spine with a local bone graft versus an iliac crest bone graft: a prospective, randomized study with a 2-year follow-up

Single-level instrumented posterolateral fusion of the lumbar spine with a local bone graft versus an iliac crest bone graft: a prospective, randomized study with a 2-year follow-up

Surgical options for lumbar spinal stenosis

Platelet leukocyte gel facilitates bone substitute growth and autologous bone growth in a goat model

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