Single-level instrumented posterolateral fusion of the lumbar spine with a local bone graft versus an iliac crest bone graft: a prospective, randomized study with a 2-year follow-up
- 17 December 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Spine Journal
- Vol. 20 (4), 635-639
- https://doi.org/10.1007/s00586-010-1656-7
Abstract
The iliac crest bone grafting (ICBG) technique for lumbar posterolateral fusion surgery is widely used; however, donor site problems such as pain and sensory disturbance have been reported. Local bone is available for fusion surgery, but its reliability as a graft has not been fully reported. In the current study, we examined single-level instrumented posterolateral fusion with a local bone graft versus an ICBG in a prospective randomized study. Eighty-two patients diagnosed with L4 degenerated spondylolisthesis were divided into two groups at random. Forty-two patients underwent instrumented posterolateral fusion with a local bone graft (L4–L5 level), and 40 patients underwent instrumented posterolateral fusion with an ICBG (L4–L5 level). Rate and duration of bone union, visual analog scale (VAS) score, Japanese orthopedic association score (JOAS), Oswestry Disability Index (ODI), and complications were evaluated before and 2 years after therapy. VAS score, JOAS, and ODI were not significantly different between the two groups before and after surgery (P > 0.05). Rate and average duration of bone union were 90% and 8.5 months in the local bone graft group, and 85% and 7.7 months in the ICBG group, but without significant difference (P > 0.05). Prolonged surgical time and complications such as donor site pain (8 patients) and sensory disturbance (6 patients) were observed in the ICBG group. If single-level posterolateral fusion was performed, local bone graft technique has the same bone union rate compared with ICBG, requires less surgical time, and has fewer complications.Keywords
This publication has 14 references indexed in Scilit:
- In situ local autograft for instrumented lower lumbar or lumbosacral posterolateral fusionJournal of Clinical Neuroscience, 2009
- Outcome of Local Bone Versus Autogenous Iliac Crest Bone Graft in the Instrumented Posterolateral Fusion of the Lumbar SpineSpine, 2006
- Iliac Crest Bone Graft Donor Site Pain After Anterior Lumbar Interbody FusionJournal of Spinal Disorders & Techniques, 2005
- Local Autograft Bone in the Surgical Management of Adolescent Idiopathic ScoliosisSpine, 2004
- 1997 Volvo Award Winner in Clinical StudiesSpine, 1997
- A Prospective, Randomized Study of Lumbar FusionSpine, 1993
- Chronic Donor Site Pain Complicating Bone Graft Harvesting From the Posterior Iliac Crest for Spinal FusionSpine, 1992
- Harvesting Autogenous Iliac Bone GraftsSpine, 1989
- Morbidity at Bone Graft Donor SitesJournal of Orthopaedic Trauma, 1989
- Sequential Treatment Assignment with Balancing for Prognostic Factors in the Controlled Clinical TrialBiometrics, 1975