Department of Orthopaedic Surgery, School of Medicine, Daegu Catholic University, Daegu Catholic University Hospital, Daegu, Korea.
Clin Spine Surg. 2022 Aug 1;35(7):E621-E626. doi: 10.1097/BSD.0000000000001330. Epub 2022 Mar 31.
Retrospective study with prospectively collected data.
The purpose of this study is to investigate the difference in fusion rate and clinical outcome of patients with local bone as filler for the graft and demineralized bone matrix (DBM) plus only the cancellous bone from local bone as a filler for cage in 1-level posterior lumbar interbody fusion (PLIF) with cage.
Cancellous bone is more advantageous than cortical bone in the local bone for improving bone formation in spine fusion surgery. There are little studies on the difference in fusion rate and reduction of fusion time using only these cancellous bones.
Of the 40 patients who underwent 1-level PLIF using cage, 20 patients in group A used local bone and 20 patients in group B used mixture of cancellous bone extracted separately from local bone and commercially available DBM as filler for cage. Changes in fusion rate and intervertebral spacing were measured using lateral radiography, and fusion was determined as nonunion using the Brantigan-Steffee classification. The clinical outcome was evaluated.
There was no difference in height change over time between the two groups. Regarding union grade, group B showed better union grade than group A. However, no difference in union grade change over time was observed between the 2 groups. In group B, Oswestry Disability Index (ODI), Rolland-Morris Disability Questionnaire (RMDQ), and SF-36 mental component score (MCS) significantly decreased, but there was no difference in change over time.
In 1-level PLIF for degenerative lumbar disease, better fusion rate was observed in the group that used only cancellous bone from local bone plus DBM than that in the group that used local bone; however, there was no difference in fusion grade change over time in the 2 groups.
回顾性研究，前瞻性收集数据。
本研究旨在探讨在 1 级后路腰椎体间融合（PLIF）中，使用局部骨作为填充物与使用局部骨的松质骨加脱钙骨基质（DBM）作为填充物的融合率和临床结果的差异。
松质骨比皮质骨更有利于改善脊柱融合手术中的骨形成。关于仅使用这些松质骨，融合率和融合时间减少的差异研究较少。
40 例接受 1 级 PLIF 融合器的患者中，20 例 A 组患者使用局部骨，20 例 B 组患者使用从局部骨中提取的单独的松质骨和市售 DBM 的混合物作为融合器的填充物。通过侧位 X 线片测量融合率和椎间间隙的变化，并采用 Brantigan-Steffee 分类法判断融合是否为未融合。评估临床结果。
两组患者的高度随时间变化无差异。关于融合等级，B 组的融合等级优于 A 组。然而，两组患者的融合等级随时间的变化无差异。B 组的 Oswestry 功能障碍指数（ODI）、Rolland-Morris 残疾问卷（RMDQ）和 SF-36 心理成分评分（MCS）显著降低，但随时间的变化无差异。
在退行性腰椎疾病的 1 级 PLIF 中，使用局部骨的松质骨加 DBM 的患者融合率高于使用局部骨的患者；然而，两组患者的融合等级随时间的变化无差异。
