Effects of different bone graft materials and osteoporosis on the success rate of posterior lumbar interbody fusion

Wang Jin-quan; Sun Yu-Qing; Xing Yong-gang

doi:10.3969/j.issn.2095-4344.2015.38.001

Abstract：BACKGROUND:For patients with osteoporosis, bone mineral density and other factors can lower the success rate of posterior lumbar interbody fusion. But there is no comprehensive report on the effects of different bone graft materials and osteoporosis on the posterior lumbar interbody fusion. <br> OBJECTIVE:To explore the influence of different bone graft materials and osteoporosis on the success rate of posterior lumbar interbody fusion. <br> METHODS:Clinical data of 227 patients undergoing posterior lumbar interbody fusion were retrospectively analyzed, and these patients were assigned into autogenous iliac bone group (n=121), fusion cage combined with autogenous cancelous bone group (combined group,n=65) and alograft group (n=41) according to different bone graft materials. There were 20, 22, 6 patients with osteoporosis in the three groups, respectively. Al the patients were folowed up for 24 months, and postoperative bone fusion, fusion time, intervertebral height and internal fixation failure and other adverse events were recorded and compared among three groups. <br> RESULTS AND CONCLUSION:The failure rate of internal fixation, fusion time and loss of intervertebral height were higher, but the fusion rate was lower in the alograft group than the other two groups (P < 0.05). In addition, there was no difference between the autogenous iliac bone group and combined group. For the osteoporosis patients, the failure rate of internal fixation and fusion time were higher, while the loss of intervertebral height and fusion ratewere lower in the alograft group than the other two groups (P < 0.05); compared with the autogenous iliac bone group, the combined group had longer fusion time and higher fusion rate (P < 0.05). These findings indicate that autogenous iliac bone graft combined with or without fusion cage can achieve higher fusion rate and less internal fixation failure in the posterior lumbar interbody fusion; however, for osteoporosis patient, the autogenous iliac bone graft can obtain better fusion effects.