Li Jiaqi, Li Shaorong, Zhang Shuowen, Liu Lin, Wang Weijian, Wu Han, Yang Qiang, Zhang Wei
Department of Spinal Surgery, the Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050000, Hebei, China.
Department of Health Management Centre, the First Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
J Orthop Surg Res. 2025 Jul 16;20(1):665. doi: 10.1186/s13018-025-06073-8.
This self-controlled study evaluates the fusion efficacy of autologous iliac bone harvested via a novel minimally invasive tool versus allogeneic demineralized bone matrix (DBM) in lateral lumbar interbody fusion (LLIF), while assessing the safety profile of the retrieval tool.
This study was a prospective clinical controlled study. Patients' basic information was recorded, including the age, gender, body mass index and etc. Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate clinical efficacy. Three parameters were measured, including intervertebral space height, intervertebral foraminal height and lumbar lordosis angle, before surgery and 3 days/24 months after surgery. Postoperative CT scan was used to compare the difference in interbody fusion between autologous iliac bone and allogeneic bone DBM at 6 and 24 months after surgery.
30 patients followed up for more than 24 months were included. The preoperative VAS for lower back and leg pain was 5.00 ± 0.87, and the preoperative ODI was 48.37 ± 8.53. The VAS for lower back and leg pain was 0.87 ± 0.63, and the ODI was 12.30 ± 2.58 at 24 months after surgery. The VAS and ODI in each postoperative stage were significantly improved compared to the preoperative (P < 0.05). The VAS of the bone extraction area was 1 (0,2) after surgery, and the pain disappeared approximately 2 days after surgery. At 6 months postoperatively, the fusion rate was 66.7% (20/30) for autologous iliac bone versus 30.0% (9/30) for allogeneic DBM (P < 0.05). the fusion rate on the autogenous iliac bone side (96.7%) was significantly higher than that on the DBM side (70.0%) at 24 months after surgery (P < 0.05).
The novel retrieval tool enables safe, minimally invasive harvest of autologous iliac bone, which achieved significantly higher fusion rates than allogeneic DBM in LLIF.
本自我对照研究评估了通过一种新型微创工具获取的自体髂骨与同种异体脱矿骨基质（DBM）在腰椎侧方椎间融合术（LLIF）中的融合效果，同时评估了该取骨工具的安全性。
本研究为前瞻性临床对照研究。记录患者的基本信息，包括年龄、性别、体重指数等。采用视觉模拟评分法（VAS）和Oswestry功能障碍指数（ODI）评估临床疗效。在手术前以及手术后3天/24个月测量三个参数，包括椎间隙高度、椎间孔高度和腰椎前凸角。术后CT扫描用于比较自体髂骨和同种异体骨DBM在术后6个月和24个月时椎间融合的差异。
纳入30例随访超过24个月的患者。术前下背部和腿部疼痛的VAS评分为5.00±0.87，术前ODI为48.37±8.53。术后24个月时，下背部和腿部疼痛的VAS评分为0.87±0.63，ODI为12.30±2.58。与术前相比，各术后阶段的VAS和ODI均有显著改善（P<0.05）。手术后骨提取区域的VAS评分为（0，2），术后约2天疼痛消失。术后6个月，自体髂骨的融合率为66.7%（20/30），同种异体DBM的融合率为30.0%（9/30）（P<0.05）。术后24个月时，自体髂骨侧的融合率（96.7%）显著高于DBM侧（70.0%）（P<0.05）。
这种新型取骨工具能够安全、微创地获取自体髂骨，在LLIF中其融合率显著高于同种异体DBM。
