Journal List > J Korean Soc Spine Surg > v.22(2) > 1076074

J Korean Soc Spine Surg. 2015 Jun;22(2):37-42. Korean.
Published online June 30, 2015.  https://doi.org/10.4184/jkss.2015.22.2.37
© Copyright 2015 Korean Society of Spine Surgery
Union Rates of Autologous Bone Marrow, Local Autobone and Biphasic Calcium Phosphate Mixed Graft in Lumbar Posterolateral Fusion
Man-Jun Park, M.D., Young-Chul Ko, M.D., Il-Soo Eun, M.D., Jung-Wook Huh, M.D., Keum-Min Hwang, M.D., Sook-Hyun Park, M.D. and Tae-Hong Park, 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: +82-51-607-2864, FAX: +82-51-607-2551, Email: vaindrgt@naver.com
Received March 18, 2015; Revised April 28, 2015; Accepted June 09, 2015.

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 retrospective study.

Objectives

We examined union rates and clinical outcomes to evaluate the efficacy of using autologous bone marrow along with a local autobone and biphasic calcium phosphate mixed graft with posterolateral fusion in spinal stenosis and spondylolisthesis.

Summary of Literature Review

In lumbar posterolateral fusion, union rates of biphasic calcium phosphate and local autobone mixed graft are low compared to union rates of autogenous iliac bone graft.

Materials and Methods

Among the patients who had lumbar posterolateral fusion with autologous bone marrow along with local autobone and biphasic calcium phosphate mixed graft between February 2013 and January 2014, we analyzed 40 patients who were available for at least one year of follow-up. There were 22 cases with spinal stenosis and 18 cases with spondylolisthesis. Bone fusion was determined along with the fusion rates based on Lenke's criteria (citation). All patients were evaluated postoperatively at one year, using 3D CT. and the clinical outcomes were assessed using Kim's method (citation).

Results

In spinal stenosis, bone union was observed in 19 cases out of 22 (86.4%), and in case of spondylolisthesis, bone union was observed in 16 cases out of 18 (88.9%). In spinal stenosis, the clinical outcomes were: 2 excellent, 16 good, 3 fair, and 1 poor; in other words 18 cases (81.8%) displayed good or excellent outcomes. In spondylolisthesis, 2 excellent, 12 good, 4 fair and 0 poor; in other words, 14 cases (77.8%) showed good or superior outcomes.

Conclusions

Posterolateral fusion using autologous bone marrow along with a local autobone and biphasic calcium phosphate mixed graft showed similar bone fusion rates to using autogenous iliac bone graft. Therefore, this method could serve as an alternative to using autogenous iliac bone graft in posterior lumbar fusion.

Keywords: Spinal stenosis; Spondylolisthesis; Posterolateral fusion; Biphasic calcium phosphate; Autologous bone marrow

Figures


Fig. 1
(A) A 72-year-old female's preoperative simple radiograph. (B) At 12-months postoperatively, the radiograph shows complete bony union of Lenke A degree. (C) At 12-months postoperatively, 3D CT shows sufficient bone mass.
Click for larger image


Fig. 2
(A) A 57-year-old male's preoperative simple radiograph. (B) At 12-months postoperatively, the radiograph shows complete bony union unilaterally of Lenke B degree. (C) At 12-months postoperatively, 3D CT shows right sufficient bone mass and left small bone mass.
Click for larger image


Fig. 3
(A) A 70-year-old female's preoperative simple (radiograph?). (B) At 12-months postoperatively, the radiograph shows bony union of Lenke C degree. (C) At 12-months postoperative 3D CT shows insufficient bone mass.
Click for larger image

Tables


Table 1
Bone Fusion Rates by Lenke's Criteria
Click for larger image


Table 2
Clinical Results by Kim's Criteria
Click for larger image

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