Application Of Surgical Autologous Particulate Bone Graft In Posterior Lumbar Interbody Fusion Surgery

Objectives:Exploring the clinical effects of posterior lumbar interbody fusion use autologous spinous prosess and lamina for special lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis and other lumbar degenerative disease.Methods: A retrospective study of 184 patients who suffering from special lumbar disc herniation, lumbar spinal stenosis and lumbar spondylolisthesis were treated with lumbar interbody fusion(PLIF and TLIF) operation in our hospital orthopedic center from January 2010 to March 2014. According to the interbody fusion material,all patients were divided into there groups,Group A:autologous cage(61 cases); Group B: PEEK cage(64cases); Group C:allogeneic bone pad(59 cases). The average follow-up time was 32months(24-72months). We compared the general information before surgery, operation time, blood loss, postoperative ambulation time, the hospital stay, the postoperative changes in the fusion rate, segment height and segment angle of postoperative interbody fusion among three groups. We used JOA score criterion to assess the clinical outcomes.Results:1、The differences of general information were not statistically significant among three groups,(P>0.05); 2、There was a non-significant difference in blood loss,operation time, postoperative ambulation time and hospital stay among three groups,(P>0.05). 3、The recovery of postoperative segment angle in group C was higher than group A and group B(P<0.05). 2 year after surgry, the differences of interbody fusion segment height and angle in there groups were not statistically significant,(P>0.05). 4、3month after surgery,all three groups improved JOA score significantly compare to before surgery. The JOA score improving ratio of three groups all reached to excellent lever.There was no significant difference in JOA score on difference time quantum among three groups,(P>0.05). 5、The fusion rate of Ⅰlevel of group A was higher than group C 1 year after surgery,(P<0.05). There was no significant difference in fusion rate among there groups or between two groups each orther 2 year after surgery,(P>0.05). 6、The complication of cage backward moving incidence of Group B was high.Conclusions: autologous spinous prosess and lamina graft in lumbar interbody fusion can maintains lumbar disc height as PEEK cage and allogeneic bone pad. This surgery method do not prolong the postoperative ambulation time and has economic benefit. So this surgery method is advocated in clinic.