Role of DBM in lumbar spinal fusion surgery

Abstract

Introduction: Spinal arthrodesis is the primary goal of all fusion procedures for lumbar spinal disease. Due to the limited availability of Autologous bone, some alternative bone graft substrate which is safe, produce similar results, and can be harvested in considerable volume was needed. Hence we explored the potentials of demineralized bone matrix (DBM) for this procedure. Purpose: We aimed to decrease the donor site morbidity to get sufficient graft and to access the efficacy of DMB in terms of anatomical and functional outcome. Methods: 30 patients were included in the study. Patients were followed up postoperatively at one year follow up. Patients were evaluated before and after the procedure using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI). The radiological outcome in the study group was assessed by using Lenke Classification of Posterolateral Fusion. Results: All patients had significant improvement in the VAS and ODI scores post operatively at one year follow up. Radiological evaluation of Lumbar fusion rates assessed with Lenke fusion Classification for PLF at the end of one year was 83.33% Grade A fusion rates which is excellent. Younger patients of either sex had better outcomes compared to the older age group patients. Conclusions: Mean improvement across all fields was 81.40% which is excellent. The available literature shows similar outcomes compared to iliac crest bone graft which is considered as the gold standard for spinal fusion. DBM can be considered as a reliable alternative to autograft when it is used as a graft extender in combination with autograft.