Bone union rate with autologous iliac bone versus local bone graft in posterior lumbar interbody fusion.
METHODS
A retrospective clinical study with a long-term follow-up in a single facility.


OBJECTIVE
The purpose of this study is to compare bone union rate between autologous iliac crest bone graft and local bone graft in patients treated by posterior lumbar interbody fusion (PLIF) using carbon cage for single-level interbody fusion.


BACKGROUND
Recently, a number of authors have reported on local bone grafting using bone that is obtained from laminectomy, and have indicated that the achieved fusion rate is similar to that of autologous iliac bone grafting. However, there is no report comparing the fusion rates between autologous iliac bone and local bone graft with a detailed follow-up of fusion progression.


METHODS
The subjects were 101 patients whose course could be observed for at least 2 years. The diagnosis was lumbar spinal canal stenosis in 14 patients, herniated lumbar disc in 19 patients, and degenerative spondylolisthesis in 68 patients. Single interbody PLIF was performed using iliac bone graft in 54 patients and local bone graft in 47 patients. Existence of pseudarthrosis on X-P (anteroposterior 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 2 groups. Donor site pain continued for more than 3 months in 6 cases (11%). The final fusion rate was 94.5% versus 95.8%.


CONCLUSIONS
Fusion results from the local bone group and the autologous iliac bone group were nearly identical. Furthermore, fusion progression was nearly identical. Complications at donor sites were seen in 17% of the cases. From the aforementioned results, it was concluded that local bone graft is as beneficial as autologous iliac bone graft for PLIF at a single level.
Ito
Zenya
Z
Department of Orthopedics, Nagoya University, 47-1-102 Takikawa-cho, Nagoya, Aichi, Japan. z.ito@nifty.com
Matsuyama
Yukihiro
Y
Sakai
Yoshihito
Y
Imagama
Shiro
S
Wakao
Norimitsu
N
Ando
Kei
K
Hirano
Kenichi
K
Tauchi
Ryoji
R
Muramoto
Akio
A
Matsui
Hiroki
H
Matsumoto
Tomohiro
T
Kanemura
Tokumi
T
Yoshida
Go
G
Ishikawa
Yoshimoto
Y
Ishiguro
Naoki
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001861:Bone Regeneration / Q000502:physiology*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult