John David Dorchak, Miller Gantt, J. Kenneth Burkus
In lumbar spinal arthrodesis surgery, bone graft substitutes are used to avoid the complications and limitations associated with autologous Iliac Crest Bone Grafts (ICBGs). Cellular Allogeneic Bone Matrices (CBMs) are used as a biologic replacement for iliac crest bone grafts in lumbar spinal fusions. Advanced cryopreservation techniques utilized during allograft processing have been used to retain native viable Mesenchymal Stem Cells (MSCs) and other osteoprogenitor cells available for transplantation. Our goal was to evaluate the clinical efficacy of the application of an advanced CBM implant used as a bone graft replacement in patients with degenerative lumbar disc disease undergoing lumbar interbody fusion surgery.
A consecutive series of fourteen patients (eight males and six females) with a mean age of 60 years (range 40 to 78 years) who underwent single or two-level Lumbar Interbody Fusion (LIF) using a cellular allogeneic bone matrix as the sole bone graft material were retrospectively reviewed. All patients were followed for a minimum of twelve months, and preoperative, three, six and twelve-month postoperative data were assessed. Lumbar fusion status was evaluated by plane and dynamic radiographs.
All patients showed successful radiographic fusion at six months after surgery with evidence of bridging trabecular bone across the interspace. There was no deterioration in fusion status between six and twelve months; all patients remained fused. There was no evidence of implant migration or subsidence. No adverse events were identified at surgery or during the course of follow-up. Improvement in back and leg pain symptoms was identified in all patients; there was no documented loss of neurological function.
The use of a cellular allogeneic bone matrix provided sufficient biological support for successful lumbar spinal interbody fusions.
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