A comparative study of clinical and radiological outcome between cages and morselized bone graft in transforaminal lumbar interbody fusion surgery: a hospital-based study

Amit Jain,Ramesh Chandra Meena,Mudit Agarwal,Abhishek Chandra,Aakanksha Agarwal

doi:10.18203/issn.2455-4510.intjresorthop20201492

Abstract

Background: Degenerative spinal diseases resulting in neuropathic backache are managed by nerve root decompression with instrumented interbody fusion is the treatment of choice for these groups of patients when not managed conservatively.Methods: Hospital based, comparative, retrospective study was carried out in such patients who underwent transforaminal lumbar interbody fusion (TLIF) with either cage with bone graft or stand-alone autologous morselized bone graft. The clinical and radiological outcomes were compared in these two methods of interbody fusion to assess any significant difference between them. A total of 20 patients with lumbar canal stenosis and degenerative grade 1/2 spondylolisthesis who failed conservative management were operated by TLIF approach and were evaluated for post-operative improvement in Oswestry disability index (ODI) and interbody fusion on imaging at 6 months and 1 year postoperatively. Vertebral level of surgical intervention, intra-operative blood loss and duration of surgery were recorded for each patient along with complications, if any.Results: In our study there was no significant difference in the clinical and radiological outcome between the two methods of interbody fusion. Although the group which was offered morselized bone graft with cage showed slightly better clinical outcome at 6 months of follow up, both showed no significant difference in ODI at 1 year of follow up.Conclusions: With this study, we can conclude that both the methods have similar clinical and radiological outcome with similar patient satisfaction and can be interchangeably employed for interbody fusion according to surgeon’s and patient’s preferences.

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