Abstract
Introduction
Local autogenous bone (LABORATORY) harvested from interlaminar fenestration or total facetectomy has been widely applied in interbody fusion of lumbar disc degenerative diseases (DDD) with satisfactory clinical results. However, there was lack of weight and volume observation of LABORATORY harvested from single interlaminar fenestration(SIF). The aim of this study was to quantitative observe the interbody fusion feasibility with LABORATORY harvested from SIF in PLIF.
Materials and Methods
107 patients were undergone PLIF only by LABORATORY+one cage at L4/5 and/or L5S1 due to DDD. The weight and volume of LABORATORY from SIF were measured by analytical balance and 5ml disposal sterile syringe. The height of cages used intraoperative were recorded. The area of endplate (Se) and the contact area (Sc) between the cartilaginous endplate and LABORATORY +cage at every intervertebral space was measured and calculated by PACS of CT workstation. The clinical results and fusion status were estimated by JOA score and 3D-CT at 12, 18 and 24 months postoperative.
Results
113 segments of 107 patients were successfully fused only by LABORATORY harvested from SIF. The weight and volume of LABORATORY from SIF showed no significant differences at different ages, genders, segments and type of DDD, and the same result exists about Se and the height of interbody space in L4/5 or L5S1 segments. The mean volume and weight of LABORATORY were 3.1ml and 3.7 g from SIF. The packing ratio (PR) of LABORATORY+one cage was 38.1%. The volume and weight to reach 30% PR needed ~2.5ml and 3.0 g LABORATORY. 94 cases (98 segments) were followed up for average 24 months postoperative. The improvement rate of JOA score was 82.5%, and the fusion rate was 92.9%.
Conclusion
SIF can provide enough LABORATORY for one interbody fusion in PLIF. The average volume and weight of LABORATORY from SIF were 3.1ml and 3.7 g respectively. 38% PR, including one cage, is achievable at fusion segment in present study. 2.5 ml (3.0 g) LABORATORY+one cage can perform ~30% PR.