Lumbar Spine Fusion Rates With Local Bone in Posterolateral and Combined Posterolateral and Interbody Approaches.
Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews
Posterolateral lumbar fusion (PLF) used to treat degenerative lumbar conditions still faces pseudarthrosis. Bone graft choice is a key factor; a traditional choice has been autologous iliac crest bone graft (ICBG), but complication rates are quoted up to 39%. Local bone from laminectomy eliminates ICBG harvesting complications.
Methods: Two hundred forty-one patients underwent either PLF or PLF with interbody at a single lumbar level with a prospective, multicenter, randomized controlled trial only using local bone graft. Fusion was assessed with radiographs and CT.
Results: PLF fused bilaterally in 18% and unilaterally in 28.8% at 6 months and 35.7% and 50.3% at 12 months, respectively. At 6-month PLF + interbody, 1.1% fused bilaterally and 11.7% unilaterally; at 12 months, 5.4% fused all three areas, and 50.8% fused at least one area.
Discussion: Local bone fused substantially less than the "benchmark" ICBG.
Park DK, Roberts R, Arnold P, Kim DH, Sasso R, Baker KC, Fischgrund JS. Lumbar Spine Fusion Rates With Local Bone in Posterolateral and Combined Posterolateral and Interbody Approaches. J Am Acad Orthop Surg Glob Res Rev. 2019 Nov 4;3(11):e018. doi: 10.5435/JAAOSGlobal-D-18-00018. PMID: 31875201; PMCID: PMC6903817.