Is local bone viable as a source of bone graft in posterior lumbar interbody fusion?

摘要

STUDY DESIGN: Radiographic evaluation of bony union and clinical outcome were investigated after posterior lumbar interbody fusion (PLIF) performed with only local bone. OBJECTIVES: To examine the viability of local bone for bone graft in PLIF. SUMMARY OF BACKGROUND DATA: Different sources of bone graft have been used for PLIF. Autologous iliac bone is most likely suitable for biologic bone healing ability, but there may be some questions such as donor site pain. Allograft and artificial bones are less effective for bone healing. Use of local bone could be a solution. However, the quality of local bone is still being questioned and there is hesitation to use local bone alone. MATERIALS AND METHODS: Thirty-two patients underwent PLIF (24 single-level and 8 double-level) using the Brantigan I/F Carbon Cage filled with local bone and segmental pedicle screw fixation. At 3, 6, and 12 months after surgery, "parallel AP view radiograph" was obtained to evaluate bony union status. Average follow-up period was26 months. Clinical outcome was also evaluated by the Japanese Orthopedic Association clinical score. RESULTS: The bony union rate was 16.7%, 72.4%, and 100% at 3, 6, and 12 months after surgery, respectively. Clinically, the average of JOA scores was improved significantly (P < 0.001). The improvement rate was 72.9% (12 mo) and 76.8% (24 mo) on average. CONCLUSIONS: A 100% bony union rate was obtained 12 months after PLIF with only local bone. The results showed that clinical viability of local bone as a source of bone graft in PLIF.