Comparaitve Study About Posterior Lumbar Interbody Fusion With Autologous Bone Or Cage For Treatment Of Degenerative Lumbar Instability

Objective: To compare clinical efficacy of posterior lumbar interbody fusion withautologous bone or Cage for treatment of Instability of lower lumbar on the basis of thepedicle screw fixation.Methods: Retrospective analysis of August2011to March2013due to degenerativelumbar instability at Affiliated Hospital of Shandong Traditional Chinese MedicineUniversity with the treatment of posterior lumbar interbody fusion of the two groups ofpatients. Pure autogenous bone fusion group23cases for the A group, among them, therewere9male and14female patients(averaged60.7years).Cage fusion group28cases forthe B group, among them, there are11male and17female patients(averaged60.9years).The follow-up period is1,6,12,18months postoperatively. Follow-up contentsinclude the height of the intervertebral space, to calculate the rate of fusion. ReferenceJapan1984Japan Society of Orthopedic Surgery (JOA) score low back pain treatmentstandard score (29points) method evaluating the fineness rate. Calculate the incidencerates of surgical complications and the adjacent segment degeneration incidence. All datawere analyzed by SPSS13.0.Results: According to operation time, blood loss, follow-up of clinical symptomsand imaging data to assessment:1.Two sets of operation time and blood loss were nosignificant difference.2. The two groups pre-operative and post-operative after a month of vertebral height was no significant difference; it was also different between twogroups post-operative after18months that the disc space height lost more significant ingroup A.3. Comparison of the two groups post-operative after six months there was nosignificant differences in fusion rates.4. Two groups post-operative after6months,12months and18months fineness rate was no significant difference.5. Two groups inincidence of surgical complications showed no significant differences, A group: one caseappeared dural tear and the cerebrospinal fluid leakage, pseudoarthrosis formation onecase. B group: two cases appeared dural tear, one case appeared the formation ofcerebrospinal fluid leakage, no pseudoarthrosis formation.6. Two groups showed nosignificant differences in adjacent joint degeneration.Conclusion: Using autogenous iliac bone graft in the operation time, the bloodloss,the medium and long-term fusion rate, clinical symptoms improved, the incidenceof surgical complications and the adjacent joint degeneration was no significantdifference with the cage fusion. And using autogenous iliac bone graft was no immunerejection, easy and cheap. But in the maintenance of intervertebral space height it wasweaker than fusion cage. Autologous bone as the same as Cage can be used forinterbody fusion for treatment of adult instability of lower lumbar;good clinical outcomecan be achieved.