Study Of The Application Of Artificial Bone Materials In TLIF

ObjectiveIn recent years, lumbar spine fusion is widely used in the treatment of low back pain caused by degenerative diseases. Compared with the Posterior Lumbar Interbody Fusion(PLIF), the Transforaminal Lumbar Interbody Fusion has its own advantages. In TLIF, by removal of one side of the articular process, we get the fusion of the vertebral body through the lateral side, without pulling the nerve root or the dural sac. In this way, we can reduce the possibility of nerve damage or cerebrospinal fluid leakage. Also, we only remove one side of the articular process, the influence for the stability of the spine is much lower than that of the PLIF. Besides, the complications such as the Spondylolisthesis and the Lumbar instability. It costs less time and less blooding in the operation, also has a more rapid recover speed and more fusion rate. In TLIF we usually face the problem of bone graft. The common source of the bone graft is autologous bone, while it increases the time of the operation, also increase the suffering of patients and other shorts. Our research is target on the possibility of the apply of artificial bone materials in TLIF, through the compare of the two methods of bone graft (the autologous bone and the artificial bone).Methods and MaterialWe have a group of 50 patients, including 24 males and 26 females. The age of patients varies from 24 to 74 years old, the mean age is 57.2 years. Time of them suffering from illness is 0.5 to 8 years, on average is 3.4 years. There were 27 segmental instability cases, among them,15 cases were the L4,5 segments; 8 cases were the L5,S1 segments; 4 cases were the L4-S1 double segments. There were 13 degenerative spondylolisthesis cases, and 10 cases of the spinal stenosis. Among the cases of the spinal stenosis, there were 5 cases of the L4,5 segments,3 cases of the L5,S1 segments, and 2 of the L4-S1 double segments.50 patients were divided into two groups, which are the autograft and artificial bone group. The autologous bone group has 27 cases, in which we use autogenous bone graft during the interbody fusion; the artificial group has 23 patients, to which we use artificial bone graft for the interbody fusion. After 3 to 6 months of follow-up, all the patients have got final follow-up, By using the visual analogue scale and the oswestry disability index, also we watch the situation of the fusion on the X-ray films to evaluate the effect of the treatment.ResultsAfter comparing the ODI and the VAS scores between before the surgery and the final follow-up, also between the to groups, we get a conclusion that there are significant differences between the one before the surgery and the final follow-up. The latter one has a better score than the former. The change of dysfunction after the surgery between the two groups has no significant difference. On the side of fusion rate, all of the patients in this research have got satisfy fusion, which can be observed that there is continuous bone trabecular growing within and around the cage.ConclusionsThe application of artificial bone material in TLIF has the same fusion rate and improvement of dysfunction with the autologous bone graft, it shorts the time of the operation time, not have to take the surgery for the bone graft. So it could reduce the blood loss, prevent the possibility of pain in the iliac bone region. Also it has reduce the rate of infection. Therefore, the use of artificial bone graft should be a future trend.