Abstract
BackgroundThe use of an interbody fusion device (cage) to assist fusion and increase intervertebral stability is widely supported. We applied the morselized impacted bone graft method without using a cage in a single level interbody fusion with encouraging medium-term clinical results. The purpose of this paper is to compare the clinical and radiological results of local bone grafts with a cage to morselized impacted bone grafts without cage, in patients undergoing transforaminal lumbar interbody fusion (TLIF) surgery.MethodsOne hundred eighty-nine consecutive patients who underwent TLIF in our hospital were evaluated from July 2009 to July 2012. Eighty-four patients received TLIF and local bone graft with one polyetheretherketone (PEEK) cage, while 96 patients received the TLIF with local morselized impacted bone grafts without a cage. The clinical data and perioperative parameters of the patients in the two groups were recorded and compared.ResultsThe mean follow-up time was 35 months. There were no significant differences in operation time and blood loss between the two groups. Single-level fusion was performed in all patients. There were no statistically significant differences between the two groups, according to the preoperative or postoperative Oswestry Disability Index (ODI) score. No statistically significant differences in fusion rate were observed between the two groups. At the final follow-up, the ratio of the disc height to vertebral height (HR) was not significantly different between the two groups.ConclusionMorselized impacted bone graft is as beneficial as local bone grafts with a cage for TLIF. Since the no cage procedure is less expensive, the morselized impacted bone graft is an affordable choice for single level TLIF, especially in less developed regions.
Highlights
The use of an interbody fusion device to assist fusion and increase intervertebral stability is widely supported
We retrospectively studied 180 patients treated with transforaminal lumbar interbody fusion (TLIF) between July 2009 and July 2012 at an average follow up of 35 months
There were no significant differences in clinical baseline data, including age, sex, Oswestry Disability Index (ODI), and levels between the two groups (Table 2)
Summary
The use of an interbody fusion device (cage) to assist fusion and increase intervertebral stability is widely supported. The purpose of this paper is to compare the clinical and radiological results of local bone grafts with a cage to morselized impacted bone grafts without cage, in patients undergoing transforaminal lumbar interbody fusion (TLIF) surgery. Transforaminal Lumbar Interbody Fusion (TLIF) is gaining wide acceptance for the treatment of the degenerative lumbar spine and has proven advantages in the restoration of the disc height, disc stabilization, nerve root decompression, and reinforcement of the anterior spinal column [2,3,4]. The use of an interbody fusion device (cage) to assist fusion and increase the stability of the construct is widely supported [5, 6]. A local morselized bone graft composed of the lamina as well as the articular and spinous processes that were obtained during posterior decompression, has proven to
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