Surgical outcomes of two kinds of demineralized bone matrix putties/local autograft composites in instrumented posterolateral lumbar fusion

• Published in: BMC musculoskeletal disorders 2021-02, Vol.22 (1), p.200-200, Article 200
• Main Authors: Chang, Dong-Gune, Park, Jong-Beom, Han, Yangjun
• Format: Article
• Language: English
• Subjects: Autografts; Back pain; Body mass index; Bone graft substitute; Bone grafts; Bone Matrix; Bone Transplantation; Bone-grafting; Care and treatment; Clinical outcomes; Composite; Computed tomography; Decompression; Demineralized bone matrix; Diabetes mellitus; Humans; Instrumented posterolateral fusion; Local autograft; Low back pain; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Nonunion; Patient outcomes; Patients; Radiography; Skin & tissue grafts; Spinal canal; Spinal fusion; Spinal Fusion - adverse effects; Spinal stenosis; Spondylolisthesis; Statistical analysis; Stenosis; Surgeons; Surgery; Surgical outcomes; Treatment Outcome
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-021-04073-3

This study aimed to assess the surgical outcomes of two kinds of demineralized bone matrix (DBM) putties/local autograft composites in instrumented posterolateral lumbar fusion (PLF). Twenty-seven fusion segments of 19 patients, who underwent decompression and instrumented PLF for lumbar spinal stenosis or degenerative spondylolisthesis less than grade 1, were included in this study. The PLF mass consisted of different two kinds of DBMs (Grafton® and DBX®) and local autograft. Next, 7.5 cc of Grafton® DBM/local autograft composite was implanted on the left side, and the same amount of DBX® DBM/local autograft composite was implanted on the right side in the same patient. The PLF masses of 54 total sides (27 Grafton® sides and 27 DBX® sides) were assessed for fusion based on both flexion/extension lateral radiographs and computed tomography images at 12 and 24 months postoperatively. Clinical symptoms were also evaluated. At 12 months postoperatively, the fusion rates for the Grafton® and DBX® sides were 59.5 and 51.9%, respectively; the difference was not statistically significant (P = 0.425). At 24 months postoperatively, the fusion rates for the Grafton® and DBX® sides increased to 70.4 and 66.7%, respectively, but the difference was still not statistically significant (P = 0.574). Diabetes mellitus, smoking, and obesity (body mass index ≥25) negatively affected the fusion rate of both the Grafton® and DBX® sides. Visual analog scores for lower back pain and leg pain and Oswestry Disability Index were significantly improved after surgery (both, P