Abstract
Background context Studies have suggested that the use of bone marrow aspirate (BMA) with HEALOS (DePuy Spine, Raynham, MA), a collagen-hydroxyapatite sponge (CHS), is an effective substitute for autologous iliac crest bone graft when used in fusion procedures of the lumbar spine. Purpose To assess clinical and radiographic outcomes after implantation of BMA/CHS in patients undergoing transforaminal lumbar interbody fusion (TLIF) with posterolateral fusion (PLF). Study design/setting Case series radiographic outcome study. Patient sample Twenty patients. Outcome measures Radiographs/computed tomography (CT) scans. Methods From September 2003 to October 2004, 20 patients (22 interbody levels) were implanted with BMA/CHS via TLIF/PLF with interbody cages and posterior pedicle screws. All patients were retrospectively identified and invited for a 2-year prospective follow-up. Plain radiographs with dynamic films and CT scans were taken, and fusion was assessed in a blinded manner. Results Follow-up averaged 27 months (range: 24–29). Primary diagnosis included spondylolisthesis (17 patients), scoliosis with asymmetric collapse (2 patients), and postdiscectomy foraminal stenosis (1 patient). The overall fusion rate was 95% (21/22 levels, 19/20 patients). Anteriorly bridging bone was observed in 91% of the anteriorly fused levels (20/22), of which 65% (13/20) occurred through and around the cage and 35% (7/20) around the cage only. Unilateral or bilateral bridging of the posterior fusion masses was observed in 91% (20/22), with 55% occurring bilaterally (12/22). In 4 (18%) cases, bridging only occurred either posteriorly (2 cases) or anteriorly (2 cases). Complications included one deep wound infection. Conclusions At the 2-year follow-up, BMA/CHS showed acceptable fusion rates in patients undergoing TLIF/PLF, and can be considered as an alternative source of graft material.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call