Comparison Between Allograft Mixed with Local Bone and Autograft in Posterolateral Lumbar Fusion / 대한척추외과학회지

STUDY DESIGN: A prospective study. OBJECTIVES: To determine the usefulness of allograft and compare the result of allograft mixed with local bone and autograft in posterolateral lumbar fusion. SUMMARY OF LITERATURE REVIEW: Allograft is used for the purpose of spinal fusion, especially in the scoliosis surgery. In some studies allograft is not recommended in posterior lumbar spinal fusion alone. MATERIALS AND METHODS: Fifteen patients underwent one level posterolateral lumbar fusion using freeze-dried allograft mixed with local bone. We compared them with twenty four patients using autogenous iliac bone graft mixed with local bone about radiographic fusion grading, duration of fusion and clinical outcomes. RESULTS: Radiographic fusion grading of allograft was 7 cases of grade 1, 5 cases of grade 2, 3 cases of grade 3, and grading of autograft was 21 cases of grade 1, 2 cases of grade 2, 1 cases of grade 3. Bone fusion was complete after 11.1 months in allograft and 6.7 months in autograft. Clinically, there were 4 excellent, 9 good, 2 fair cases in allograft and 10 excellent, 11 good, 3 fair cases in autograft. CONCLUSIONS: Allograft was inferior to autograft in posterolateral lumbar fusion because allograft mixed with local bone reduced radiographic fusion grading and prolonged duration of bone fusion.

Change of Segmental Motion After Lumbar Posterolateral Fusion / 대한정형외과학회잡지

PURPOSE: To verify the changes of segmental motion after posterolateral lumbar fusion. MATERIALS AND METHODS: Thirty-eight cases of lumbar posterolateral fusion with good postoperative results and full range of motion, followed up for at least one year were reviewed. We measured the translation and angulation by the Dupuis method on flexion extension radiographs. RESULTS: 1) The motion at adjacent segments was 0.75 mm translation and 6.5 degree angulation at L1-2, 0.75 mm and 8.62 degree at L2-3, 0.95 mm and 9.67 degree at L3-4, 1.17 mm and 10.67 degree at L4-5 and 0.41 mm and 7.41 degree at L5-S1. The motion at L5-S1 was less than that in the control group, but at other levels it was not different. 2) The total range of motion of lumbar spine in the control group was 47.8 degree. In one-segment fusion the range of motion was 31.1 degree(64.9%), in two-segment fusion was 26.8 degree(56.1%) and in three-segment fusion was 14.3 degree(29.8%). The longer the fusion level was, the smaller the total range of motion of lumbar spine was. 3) The percentage of motion at adjacent mobile segments in the fusion group increased more significantly than that in the control group. CONCLUSIONS: Segmental motion at adjacent segment in the fusion group was similar to the motion in the control group. The compensatory increased motion at adjacent mobile segment was not definite, however, the percentage of motion at adjacent segment increased after spinal fusion.