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Lumbar Spine Fusion Rates With Local Bone in Posterolateral and Combined Posterolateral and Interbody Approaches.

PMID: 31875201 (view PubMed database entry)
DOI: 10.5435/jaaosglobal-d-18-00018 (read at publisher's website )
PMCID: PMC6903817 (free full text version available)

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Daniel K Park, Richard Roberts, Paul Arnold, David H Kim, Rick Sasso, Kevin C Baker, Jeffrey S Fischgrund,

Posterolateral lumbar fusion (PLF) used to treat degenerative lumbar conditions still faces pseudarthrosis. Bone graft choice is a key factor; a traditional choice has been autologous iliac crest bone graft (ICBG), but complication rates are quoted up to 39%. Local bone from laminectomy eliminates ICBG harvesting complications. Methods:Two hundred forty-one patients underwent either PLF or PLF with interbody at a single lumbar level with a prospective, multicenter, randomized controlled trial only using local bone graft. Fusion was assessed with radiographs and CT. Results:PLF fused bilaterally in 18% and unilaterally in 28.8% at 6 months and 35.7% and 50.3% at 12 months, respectively. At 6-month PLF + interbody, 1.1% fused bilaterally and 11.7% unilaterally; at 12 months, 5.4% fused all three areas, and 50.8% fused at least one area. Discussion:Local bone fused substantially less than the "benchmark" ICBG.

J Am Acad Orthop Surg Glob Res Rev (Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews)
[2019, 3(11):e018]

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