Two-year Outcome of Hydroxyapatite Mixed with Autogenous Bone Marrow and Local Bone Graft for Posterolateral Lumbar Fusion
Vera Sathira-Angkura MD*, Sombat Kunakornsawat MD*, Bunsin Assawachutithamrong MD**, Rachata Tungsiripat MD***
Affiliation : * Institute of Orthopedics, Lerdsin General Hospital, Bangkok, Thailand ** Pua Crown Prince Hospital, Nan, Thailand *** Ramkhamhaeng Hospital, Bangkok, Thailand
Objective : To determine the outcome of hydroxyapatite (HA) mixed with autogenous bone marrow (BM) and local bone graft
in posterolateral lumbar fusion.
Material and Method: Twenty-three patients who had posterolateral fusion with posterior instrument using HA mixed with
BM and local bone graft between December 2003 and August 2005 were prospective analyzed. Degree of pain using visual
analog scale (VAS) was evaluated at preoperative and 2, 4, 6, 9, 12, and 24 postoperative months. Radiographs were
assessed for spinal fusion at 4, 6, 9, 12, and 24 postoperative months.
Results : The improvement of pain was demonstrated in all patients postoperatively. Radiographic outcomes revealed solid
and doubtful fusion in one of 23 patients (4.3%) and 13 of 23 patients (56.5%) at six months respectively. After two-year
follow-up, one patient had solid fusion while 22 patients (95.6%) had doubtful fusion.
Conclusion : Despite the posterolateral lumbar fusion using HA mixed with BM and local bone graft provided good clinical
results, the radiographic results of spinal fusion were questionable in most cases.
Keywords : Hydroxyapatite, Posterolateral fusion
