J Korean Soc Spine Surg.  2020 Jun;27(2):39-47. 10.4184/jkss.2020.27.2.39.

Volumetric Assessment of Fusion Mass and Its Clinical Correlations in Posterior Lumbar Interbody Fusion Depending on the Type of Bone Graft

• Lee JW
• Li QY
• Kang KT
• Chang BS
• Lee CK
• Yeom JS
• Kim HJ

• KMID: 2503670
• DOI: http://doi.org/10.4184/jkss.2020.27.2.39

Abstract

Study Design: A prospective observational cohort study.
Objectives
This study was conducted to analyze associations between the volume of the fusion mass and clinical outcomes 1 year after posterior lumbar interbody fusion (PLIF). Summary of Literature Review: No study has investigated associations between the size of the fusion mass and clinical outcomes after PLIF.
Materials and Methods
The volume of the fusion mass and its clinical correlations after PLIF were analyzed in all patients and in subgroups. When a sufficient amount of local bone was available for grafting, only local bone without a graft extender was used (LbG group, n=20). If an inadequate amount of local bone was present for grafting, a local bone graft with porous hydroxyapatite bone chips was used (LbHa group, n=20). The same amount of demineralized bone matrix was used in both groups. The primary outcome was the relationship between the size of the fusion mass and clinical outcomes in all patients 1 year after surgery. The secondary outcome was a comparison of the size of the fusion mass and clinical outcomes by group.
Results
The volume of the fusion mass was not correlated with any clinical outcomes 1 year after surgery, either in the overall group of patients or in the subgroup analysis.
Conclusions
The volume of the interbody fusion mass was not related to any clinical outcomes 1 year after surgery. Furthermore, in cases with an insufficient amount of local bone for grafting, porous hydroxyapatite could be a relatively good alternative as a graft extender.

Keyword

Lumbar spinal stenosis; Fusion mass; Hydroxyapatite; Posterior lumbar interbody fusion