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Abstract
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 followup. 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.
REFERENCES
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Figures and Tables%
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.
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.
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.
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