Author(s)

Bodin Arnaud¹, Barnouin Laurence^2*, Coulomb Remy³, Haignere Vincent³, Kouyoumdjian Pascal^3,4

¹Department of Orthopaedic and Traumatological Spine Surgery, Groupe Hospitalier Mutualiste, Grenoble, France.
²Tissue Bank of France, Mions, France.
³Department of Orthopaedic and Traumatologic Surgery & Spinal Surgery, Centre Hospitalier Universitaire, Nîmes, France.
⁴LMGC, Université de Montpellier, CNRS, Montpellier, France.

Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred; Oswestry disability index (ODI) and pain were also evaluated. Results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P < 0.0001). No differences were found in ODI, pain and nonunion rate between groups. Intraoperative blood loss was lower in the DBM group compared to the control group but not significantly. There were no complications during or after the surgery. Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.

Spine Surgery, Demineralized Bone Fibers, Bone Substitutes, Retrospective Study

Arnaud, B. , Laurence, B. , Remy, C. , Vincent, H. and Pascal, K. (2024) Demineralized Bone Matrix Fibers plus Allograft Bone for Multilevel Posterolateral Spine Fusion: A Game Changer?. Open Journal of Orthopedics, 14, 105-113. doi: 10.4236/ojo.2024.142011.