Bone Union Rate Following Instrumented Posterolateral Lumbar Fusion: Comparison between Demineralized Bone Matrix versus Hydroxyapatite

ABSTRACT

STUDY DESIGN: Retrospective study. PURPOSE: To compare the union rate of posterolateral lumbar fusion (PLF) using demineralized bone matrix (DBM) versus hydroxyapatite (HA) as bone graft extender. OVERVIEW OF LITERATURE: To our knowledge, there has been no clinical trial to compare the outcomes of DBM versus HA as a graft material for PLF. METHODS: We analyzed prospectively collected data from consecutive 79 patients who underwent instrumented PLF. Patients who received DBM were assigned to group B (n=38), and patients who received HA were assigned into group C (n=41). The primary study outcome was fusion rate assessed with radiographs. The secondary outcomes included pain intensity using a visual analogue scale, functional outcome using Oswestry disability index score, laboratory tests of inflammatory profiles and infection rate. RESULTS: One year postoperatively, bone fusion was achieved in 73% in group B and 58% in group C without significant difference between the groups (p=0.15). There were no differences between the groups with respect to secondary outcomes. CONCLUSIONS: DBM would provide noninferior outcomes compared to the HA as a fusion material for PLF, and could be a notable alternative.