title: Bone marrow concentrate with allograft equivalent to autograft in lumbar fusions.
abstract: METHODS
  Prospective randomized study.
  
  
  OBJECTIVE
  To compare autologous bone marrow concentrate mixed with allograft cancellous bone to iliac crest autograft in lumbar fusions.
  
  
  BACKGROUND
  Bone marrow has been shown to be a rich source of osteoprogenitor cells. Osteoprogenitor cells have been shown in animals, and some human studies, to have potential in use as a bone graft substitute.
  
  
  METHODS
  Twenty-five patients underwent from 1- to 3-level lumbar fusions. One patient was lost to follow-up. On one half of the spine, allograft plus autologous bone marrow concentrate was used, whereas on the other half, autologous iliac crest bone was used. Cellular analysis, consisting of nucleated cell count, mononuclear cell count, CD34+ count, and colony-forming-units-fibroblast count, was done on marrow aspirates and concentrates. At 1 year postoperation, computed tomographic scans of the fusions were evaluated on a blinded basis by 2 neuroradiologists independent of each other. Radiographical fusion was the primary outcome measure.
  
  
  RESULTS
  There was no statistical difference in fusion scores between allograft and autograft in the lateral gutters, interbody cages, or facet joints. There was a positive trend between CD34+ counts and radiographical fusion.
  
  
  CONCLUSIONS
  The study shows equivalence between cancellous allograft mixed with bone marrow concentrate and autologous iliac crest bone for lumbar fusions.
  
  
  METHODS
  2.
authors: From the Neurosurgical Associates of San Antonio, San Antonio, TX.
authors: Robert G
authors: RG
authors: Johnson
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion / Q000379:methods*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome