To evaluate the long-term results of an anterior lumbar interbody fusion with posterior instrumentation using a single autogenous tricortical iliac graft, and to identify factors affecting results.

This study included 91 patients, 117 levels underwent anterior lumbar interbody fusion with posterior instrumentation. Radiological and clinical results were evaluated and factors affecting the results were analyzed.

An average area of the graft was 213.3 mm2; 20.2% of the contacting end-plate. Ninety-two percent of levels obtained bony fusion and 87% of patients showed excellent or good clinical results. Compensation status was a significant prognostic factor. Patient's age, sex and graft size showed no significant relationship with the results.

Our data suggest that a single block of autogenous tricortical iliac bone is sufficient for acceptable results in cases of anterior lumbar interbody fusion combined with posterior instrumentation.