A Prospective Randomized Controlled Study--Comparison Of The Clinical Effects Of Interbody Fusion With Cage Or Autogenous Morselized Bone In The Single Segment TLIF To Treat Degenerative Lumbar Spinal Stenosis

Objective To compare the the clinical effects of Cage or autogenous morselized bone used in the single segment TLIF to treat degenerative lumbar spinal stenosis.Method87patients received a single segment TLIF surgery were randomly divided into group A or B. A Cage was implanted into intervertebral space in group A patient, Autogenous morselized bone was implanted into intervertebral space in group B patient. Operation time, blood loss, length of stay, cost of hospitalization of two groups were recorded. All patients were followed up at1week,6,12,24months after operation. Postoperative Oswestry disability index(ODI), VAS scores, the fusion rates, intervertebral space and foramen height restoration, Lumbar lordosis, postoperative complications and adjacent segment degeneration rates were compared between two groups.Results1.There is no significant difference between two groups in operative time, blood loss, length of stay. however, the average hospitalization cost in Cage group were18%higher than that of autogenous bone group (P=1.2x10-7).2. Both groups of patients achieved good clinical results within two years, ODI, VAS score improvement rates, efficiencies of operation and postoperative complication rates were not statistically different.3. Lumbar fusion rate was86.7%of Cage group and85.7%of bone graft group after2years, which showed no significant difference (P=0.89); The heights of intervertebral space and foramen in Group Cage got a better recovery than those of bone graft group. Both groups had similar improvements of Lumbar lordosis.Conclusion For single segment TLIF to treat degenerative lumbar spinal stenosis with pedicle screws and rods system, usage of interbody cage can be more effective in terms of the recovery of the intervertebral space and foraminal height compared with the usage of bone graft, but it did not bring an extra contribution to the clinical efficacy, and the usage of autogenous morselized bone cost less. Two grafting methods get similar overall clinical effects, fusion rates, complication rates and adjacent segment degeneration rates.