Effect Analysis On Mixed Bone Cement Grafting With Autologous Bone And Allograft Bone In Instrumented Posterolateral Lumbar Interbody Fusion Of Lumbar Spondylolisthesis

[Objective]Autogenous bone usually use in early PLIF of Lumbar spondylolisthesis, the bone graft is easy and the result show well. The amount of bone is limited and complication in iliac bone, allogeneic bone used for bone graft as supplement. Some show that allogeneic bone may be absorbed and nearthrosis may take place then. Mixed bone cement grafting with autologous bone and allograft bone were chosen in PLIF and follow it up, analysis the effect in posterior lumbar interbody fusion of lumbar spondylolisthesis.[Methods]86 patients whose diagnosis were lumbar spondylolisthesis and underwent instrumented posterolateral fusion in spinal department of our hospital from April, 2009 to March,2011 was chosen randomly.27 males and 59 females, all of them were separated into 2 teams by autologous bone cement grafting and mixed bone cement grafting. PLIF was chosen for instrumented posterolateral fusion. Collect the operation time and blood loss. Then made a follow-up from 26 months to 29 months, estimate clinical effect referenced to VAS, ODI and JOA score, make an observation on X-ray、CT of patients after 3、12、24 months point, measure the height of intervertebral space, then analysis the bone rate of them with standard by Suk.[Results]No significant differences were found in operation time and blood loss.96.77%(30/31 cases) and 93.02%(40/43 cases) showed satisfactory in clinical effect respectively. 83.87%(26/29cases) and 79.07%(34/43cases) of two teams reached relative well bone-fusion in 12 months. No significant differences were found in bone rate.[Conclusion]Screw fixation can provide stabilization in short-term, effective and long-term stabilization need the fusion of bone graft. Stable internal fixation, enough bone graft, suitable way of fusion can improve the bone strength, decrease the complication and occurrence rate of nearthrosis. The amount of autologous bone is usually limited, the application of allograft bone solved this problem, and no significant differences were found in operation time and blood loss. Bone absorption and bone formation and some characteristics were found in the fusion progress. Cortical in mixed bone cement show high and compact density, absorption was in a dominant position in early progress, the density decreased but dense bone can be found in the edge part. The density gradually stabilized in 12 months and bone formation gradually in a dominant position. The bone graft became more compact and more even in 24 months after the surgery.