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

Eur Spine J. 2011 Apr;20(4):635-9. doi: 10.1007/s00586-010-1656-7. Epub 2010 Dec 17.

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Loss, Surgical
  • Bone Transplantation / methods*
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Humans
  • Ilium / surgery*
  • Incidence
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Pain Measurement
  • Prospective Studies
  • Spinal Fusion / methods*
  • Spondylolisthesis / surgery*
  • Surgical Wound Infection / epidemiology
  • Treatment Outcome