Abstract
Introduction
Prospective randomized radiological comparative study on the status of fusion in single level instrumented posterolateral lumbar fusion in low-grade spondylolisthesis using local bone graft versus iliac crest bone graft and local bone versus β-tricalcium phosphate and local bone graft.
Materials and Methods
A total of 24 patients in three groups with degenerative low-grade spondylolisthesis with stenosis randomly underwent decompressive laminectomy and single level instrumented posterolateral fusion with either local bone only or iliac crest bone graft with local bone or β-tricalcium phosphate and local bone graft. Each group consisted of eight patients and was followed for a minimum of 2 years after which a CT scan was done to evaluate the fusion mass according to the Lenke et al classification system.
Results
At the end of 2 years, no pseudoarthrosis was observed in either of the three groups. In the local bone graft only group, four (50%) patients had a definite solid fusion mass while the remaining four (50%) had a probable solid fusion mass. In the iliac crest group, seven (87.5%) had a definite fusion mass while one patient had a probable fusion mass. In the β-tricalcium phosphate group, five (62.5%) patients had a definite fusion while three (37.5%) had a probable solid fusion mass. Although iliac crest graft remains as the gold standard, its associated donor site morbidity has limited its use. Hence, local bone graft or substitutes such as β-tricalcium phosphate are frequently used. However, there seems to be no significant advantage of β-tricalcium phosphate over iliac crest graft in terms of the fusion status.
Conclusion
Although iliac crest bone graft remains the gold standard in lumbar fusion procedures, its associated morbidity limit its usage. Hence, local bone alone or combined with β-tricalcium phosphate are frequently used. However, there is no significant advantage of β-tricalcium phosphate over the local bone graft or iliac crest graft in terms of the fusion status.
None declared
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