Is It Possible to Get Better Results in Bone Fusion in Laminoplasty Surgery for Lumbar Stenosis? A Novel Autologous Bone Graft Insertion Technique


Aim:

Laminectomy and fusion are the most commonly used treatment options for spinal stenosis surgery due to degenerative spine diseases. Poor results like instability and deformity following laminectomy lead to the development of laminoplasty methods. Various laminoplasty techniques have been demonstrated according to the pathology’s level and extent, clinical presentation, and the surgeon’s preference. In this study, autologous bone graft insertion technique was defined and its effect on bone fusion and results were discussed with relevant literature.


Material and methods:

Fifty-six patients and 142 vertebrae that underwent autologous bone graft insertion technique between 2009 and 2018 were analysed retrospectively. Demographic data, comorbidities, and perioperative findings of patients were recorded. The midline anteroposterior (AP) diameter was measured at the bone graft insertion levels, and fusion formation was evaluated with computed tomography (CT) and dynamic X-Ray images. Pain scores were assessed preoperatively with the visual analogue scale (VAS) for both legs and Oswestry Disability Index (ODI) for overall life quality. Scores were re-evaluated on postoperative days 1 and 3 and 12 months later.


Results:

Degenerative spinal stenosis was present in 56 patients who underwent autologous bone graft insertion technique. It was found that the diameter of the spinal canal increased by 37% in CT measurements. In postoperative radiological follow-ups, fusion developed in 49 (87.5%) patients. There was a significant decrease in VAS and ODI scores at the postoperative day 1, 3rd, and 12th months compared to the preoperative period.


Conclusion:

Bone graft insertion technique supports posterior fusion and protects against dural injuries during revision surgery by creating a barrier over the dura. The prevention of epidural fibrosis formation reduces the symptoms of the postlaminectomy syndrome. The fact that this technique does not require fixation material. Therefore, it reduces expenditure and eliminates the risk of complications related to synthetic materials.

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