Comparison of intervertebral fusion rates of different bone graft materials in extreme lateral interbody fusion

Medicine (Baltimore). 2019 Nov;98(44):e17685. doi: 10.1097/MD.0000000000017685.

Abstract

To compare imaging indicators and clinical effects of extreme lateral interbody fusion (XLIF) using allogenic bone, autologous bone marrow + allogenic bone, and rhBMP-2 + allogenic bone as bone graft materials in the treatment of degenerative lumbar diseases.This was a retrospective study of 93 patients with lumbar interbody fusion who underwent the extreme lateral approach from May 2016 to December 2017. According to the different bone graft materials, patients were divided into allogenic bone groups (group A, 31 cases), rhBMP-2 + allogenic bone (group B, 32 cases), and autologous bone marrow + allogenic bone (group C, 30 cases). There were no significant differences in gender, age, lesion segment, preoperative intervertebral space height, and preoperative Oswestry Dysfunction Index (ODI) and visual analogue scale (VAS) scores among the 3 groups (P > .05). Intervertebral space height, bone graft fusion rate, and ODI and VAS scores were compared immediately after surgery, and at 3, 6, and 12 months after surgery.All groups were followed up for 12 months. The intervertebral space height was significantly higher in the 3 groups immediately after surgery and at 3, 6, and 12 months after surgery, in comparison to before surgery (P < .05). There was no significant difference in the intervertebral space height among the 3 groups immediately after surgery and at 3, 6, and 12 months after surgery (P > .05). The fusion rate of group B and C was higher than that of groups A at 3, 6, and 12 months after surgery (P < .05). In the 3 groups, the VAS and ODI scores at 3, 6, and 12 months after surgery were significantly improved compared with the preoperative scores (P < .05). The VAS and ODI scores in groups B and C were significantly higher than those in group A (P < .05), but there was no significant difference between groups B and C (P > .05).The rhBMP-2 + allograft bone combination had good clinical effects and high fusion rate in XLIF.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Bone Marrow Transplantation / methods*
  • Bone Morphogenetic Protein 2 / administration & dosage*
  • Bone Transplantation / methods*
  • Female
  • Humans
  • Intervertebral Disc Degeneration / surgery*
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Pain Measurement
  • Physical Functional Performance
  • Recombinant Proteins / administration & dosage
  • Retrospective Studies
  • Spinal Fusion / methods*
  • Transforming Growth Factor beta / administration & dosage*

Substances

  • Bone Morphogenetic Protein 2
  • Recombinant Proteins
  • Transforming Growth Factor beta
  • recombinant human bone morphogenetic protein-2