Bone Union Rate With Autologous Iliac Bone Versus Local Bone Graft in Posterior Lumbar Interbody Fusion

Ito, Zenya; Matsuyama, Yukihiro; Sakai, Yoshihito; Imagama, Shiro; Wakao, Norimitsu; Ando, Kei; Hirano, Ken‐ichi; Tauchi, Ryoji; Muramoto, Akio; Matsui, Hiroki; Matsumoto, Tomohiro; Kanemura, Tokumi; Yoshida, Go; Ishikawa, Yoshimoto; Ishiguro, Naoki

doi:10.1097/brs.0b013e3181de4f2e

Cited by 97 publications

(68 citation statements)

References 17 publications

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“…Ito compared the bone union rate in 101 patients who received either an autologous iliac crest bone graft or a local bone graft with PLIF using carbon cages at 2 years follow-up. He found a fusion rate of 94.5 versus 95.8 % observed by plane radiography [21].…”

Section: Discussionmentioning

confidence: 96%

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

et al. 2012

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Purpose Due to the disadvantages of iliac crest bone and the poor bone quality of autograft gained from decompression surgery, alternative filling materials for posterior lumbar interbody fusion cages have been developed. b-Tricalcium phosphate is widely used in cages. However, data regarding the fusion rate of b-TCP assessed by computer tomography are currently not available. Materials A prospective clinical trial involving 34 patients (56.7 years) was performed: 26 patients were treated with single-level, five patients double-level and three patients triple-level PLIF filled with b-TCP and bone marrow aspirate perfusion, and additional posterior pedicle screw fixation. Fusion was assessed by CT and X-rays 1 year after surgery using a validated fusion scale published previously. Functional status was evaluated with the visual analogue scale and the Oswestry Disability Index before and 1 year after surgery. Results Forty-five levels in 34 patients were evaluated by CT and X-ray with a follow-up period of at least 1 year. Clinically, the average ODI and VAS for leg and back scores improved significantly (P \ 0.001). CT assessment revealed solid fusion in 12 levels (26.67 %) and indeterminate fusion in 15 levels (34.09 %). Inadequate fusion (non-union) was detected in 17 levels (38.63 %). Conclusion The technique of PLIF using b-TCP yielded a good clinical outcome 1 year after surgery, however, a high rate of pseudoarthrosis was found in this series therefore, we do not recommend b-TCP as a bone graft substitute using the PLIF technique.

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Section: Discussionmentioning

confidence: 96%

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

et al. 2012

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“…We reported about a retrospective study conducted at a single facility previously [13], whereas the present study is a retrospective study conducted at multiple facilities. As at the single facility, the result indicates no difference between iliac bone and local bone grafts at the multiple facilities.…”

Section: Discussionmentioning

confidence: 96%

Bone union rate with autologous iliac bone versus local bone graft in posterior lumbar interbody fusion (PLIF): a multicenter study

et al. 2013

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Purpose The purpose of this study is to compare bone union rate between autologous iliac bone and local bone graft in patients treated by posterior lumbar interbody fusion (PLIF) using carbon cage for single level interbody fusion. Methods The subjects were 106 patients whose course could be observed for at least 2 years. The diagnosis was lumbar spinal canal stenosis in 46 patients, herniated lumbar disk in 12 patients and degenerative spondylolisthesis in 51 patients. Single interbody PLIF was done using iliac bone graft in 53 patients and local bone graft in 56 patients. Existence of pseudo-arthrosis on X-P (AP and lateral view) was investigated during the same follow up period.Results No significant differences were found in operation time and blood loss. Significant differences were also not observed in fusion grade at any follow up period or in fusion progression between the two groups. Donor site pain continued for more than 3 months in five cases (9 %). The final fusion rate was 96.3 versus 98.3 %. Conclusions Almost the same results in fusion were obtained from both the local bone group and the autologous iliac bone group. Fusion progression was almost the same. Complications at donor sites were seen in 19 % of the cases. From the above results, it was concluded that local bone graft is as beneficial as autologous iliac bone graft for PLIF at a single level.

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“…without any other supplement was not inferior in fusion rate to autologous iliac crest bone graft when used for short level interbody or posterolateral fusion [11,12]. These results imply that local bone obtained as a by-product of decompression can be enough in quantity and quality to achieve fusion for single or double level lumbar fusion in many cases and pose a question on the usage of costeffectiveness of additional graft extenders.…”

Section: Discussionmentioning

confidence: 84%

“…Though autologous iliac crest graft became a gold-standard material for spinal fusion with fusion rate up to 98.9% [6], the morbidities from the donor site including pain, hematoma, infection, fracture and neurovascular injury resulting from the procedure of harvest let patients and surgeons hesitate to accept it as a primary choice for graft material [7][8][9][10]. Recently, for short level fusion of lumbar spine, local decompressed bone without supplementary graft material was reported to be enough to get satisfactory result [11,12]. However, while with insufficient local decompressed bone in quantity and quality, alternative fusion materials are necessary to avoid disadvantages of autologous iliac bone graft.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of porous hydroxyapatite bone chip as an extender of local bone graft in posterior lumbar interbody fusion

et al. 2011

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Objective To evaluate whether a synthetic bone chip made of porous hydroxyapatite can effectively extend local decompressed bone graft in instrumented posterior lumbar interbody fusion (PLIF). Methods 130 patients, 165 segments, who had undergone PLIF with cages and instrumentation for single or double level due to degenerative conditions, were investigated retrospectively by independent blinded observer. According to the material of graft, patients were divided into three groups. HA group (19 patients, 25 segments): with hydroxyapatite bone chip in addition to autologous local decompressed bone, IBG group (25 patients, 28 segments): with autologous iliac crest bone graft in addition to local decompressed bone and LB group (86 patients, 112 segments): with local decompressed bone only. Radiologic and clinical outcome were compared among groups and postoperative complications, transfusion, time and cost of operation and duration of hospitalization were also investigated. Results Radiologic fusion rate and clinical outcome were not different. Economic cost, transfusion and hospital stay were also similar. But operation time was significantly longer in IBG group than in other groups. There were no lasting complications associated with HA and LB group with contrast to five cases with persisting donor site pain in IBG group. Conclusion Porous hydroxyapatite bone chip is a useful bone graft extender in PLIF when used in conjunction with local decompressed bone.

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Bone Union Rate With Autologous Iliac Bone Versus Local Bone Graft in Posterior Lumbar Interbody Fusion

Cited by 97 publications

References 17 publications

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

Bone union rate with autologous iliac bone versus local bone graft in posterior lumbar interbody fusion (PLIF): a multicenter study

The efficacy of porous hydroxyapatite bone chip as an extender of local bone graft in posterior lumbar interbody fusion

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