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Park, Ko, Jung, Eun, Kim, Kim, and Hwang: Union Rates of Local Autobone and β-Tricalcium Phosphate Mixed Graft in Lumbar Posterolateral Fusion
Original Article

Journal of Korean Spine Surg 2013;20(3):71-76.

Published online: 21 September 2013

DOI: https://doi.org/10.4184/jkss.2013.20.3.71

Union Rates of Local Autobone and β-Tricalcium Phosphate Mixed Graft in Lumbar Posterolateral Fusion

Man-Jun Park, M.D., Young-Chul Ko, M.D., Chul-Young Jung, M.D., Il-Soo Eun, M.D., Chang-Kyu Kim, M.D., Min-Woo Kim, M.D., Keum-Min Hwang, M.D.

Department of Orthopedic Surgery, Busan Medical Center, Busan, Korea

Corresponding author: Young Chul Ko, M.D. Department of Orthopedic Surgery, Busan Medical Center, 359 Worldcup-daero, Yeonje-gu, Busan, Korea TEL: 82-51-607-2866, FAX: 82-51-607-2551 E-mail: panggul@naver.com

Received 21 March 2013       Revised 3 May 2013       Accepted 10 September 2013

Copyright © 2013 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A retroprospective study.

Objectives

We used a local autobone and β-tricalcium phosphate mixed graft with posterolateral fusion in spinal stenosis and spondylolisthesis and evaluated union rates to verify the efficacy.

Summary of Literature Review

Several reports have shown high union rates of posterolateral fusion using β-tricalcium phosphate. However, in Korea, only one study reported a low union rate.

Materials and Methods

Forty-two patients who underwent lumbar posterolateral fusion with a local autobone and β-tricalcium phosphate mixed graft from September 2010 to July 2011 were followed up. There were 32 cases with spinal stenosis and 10 cases with spondylolisthesis. Bone fusion was determined along with the fusion rates based on Lenke's criteria. Clinical outcomes were determined using Kim's method.

Results

In spinal stenosis, bone union was presented in 19 cases(59.4%) out of 32 cases and in spondylolisthesis, bone union was presented in 7 (70.0%) out of 10. In spinal stenosis, 12 cases showed excellent outcome, 16 good, 3 fair and 1 poor, 27 cases(87.5%) were superior to the good. In spondylolisthesis, 2 cases showed excellent outcome, 5 good, 3 fair and 0 poor, 8 cases(70.0%) were superior to the good.

Conclusions

Posterolateral fusion using a local autobone and β-tricalcium phosphate mixed graft showed lower bone fusion rates. We need further studies to enhance the fusion rate when using local autobone and β-tricalcium phosphate mixed grafts.

Keywords: Spinal stenosis, Spondylolisthesis, β, -tricalcium phosphate, Posterolateral fusion

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Figures and Tables%

Fig. 1.
(A) A 54-year-old male's preoperative simple radiograph shows spinal stenosis L3-5. (B) At a postoperative 12 months, radiograph shows complete bony union of Lenke A degree.
jkss-20-71f1.tif
Fig. 2.
(A) A 75-year-old female's preoperative simple radiograph shows spinal stenosis L4-S1. (B) At a postoperative 12 months, radiograph shows complete bony union unilaterally of Lenke B degree.
jkss-20-71f2.tif
Fig. 3.
(A) A 56-year-old male's preoperative simple radiograph shows spinal stenosis L4-5. (B) At a postoperative 12 months, radiograph shows bony union of Lenke C degree.
jkss-20-71f3.tif
Table 1.
Bone fusion rates by Lenke's criteria
Spinal stenosis Spondylolisthesis Total
A 16 (51.6%) 5 (45.4%) 21 (50.0%)
B 7 (22.6%) 3 (27.3%) 10 (23.8%)
C 8 (25.8%) 3 (27.3%) 11 (26.2%)
D 0 (%) 0 (0%) 0 (%)
Total 31 (100%) 11 (100%) 42 (100%)
Table 2.
Patients’ demographics
Union group (n=26) Nonunion group (n=16) p-value
Mean Age (years) 65.7 60.6 0.143
Mean BMI (kg/m2) 24.07 25.06 0.449
Smoking 4 5 0.265
DM 5 4 0.711
Table 3.
Clinical results by Kim's criteria
Spinal stenosis Spondylolisthesis Total
Excellent 12 (37.5%) 2 (20.0%) 14 (33.3%)
Good 16 (50.0%) 5 (50.0%) 21 (50.0%)
Fair 3 (9.4%) 3 (30.0%) 6 (14.3%)
Poor 1 (3.1%) 0 (%) 1 (2.4%)
Total 32 (100%) 10 (100%) 42 (100%)
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