• Mikinobu Takeuchi, Norimitsu Wakao, Mitsuhiro Kamiya, Atsuhiko Hirasawa, Shuntaro Hanamura, Koji Osuka, and Masakazu Takayasu.
• *Spine Center, Aichi Medical University, Nagakute, Japan; Departments of ‡Neurological Surgery and §Orthopedic Surgery, Aichi Medical University, Nagakute, Japan; ¶Department of Orthopedic Surgery, Asahi Hospital, Kasugai, Japan.
• Neurosurgery. 2015 Oct 6.

BackgroundThe impaction bone grafting technique is a popular approach for achieving complete bone fusion during hip surgery or total knee arthroplasty. We hypothesized that compaction bone grafting (CBG), a modified version of impaction bone grafting, could be applied to lumbar fusion surgery.ObjectiveTo compare the bone fusion rates and durations achieved using the CBG technique and a conventional loose bone grafting technique.MethodsWe retrospectively reviewed 89 patients who underwent single-level posterior lumbar interbody fusion at the university hospital; 35 other posterior lumbar interbody fusion recipients were excluded due to undergoing multilevel fusion, prior lumbar surgery, trauma, infection, or inadequate computed tomographic data. Computed tomographic-based bone fusion assessments were obtained using the Brantigan, Steffee, and Fraser criteria at 1 and 2 years after surgery.ResultsThe baseline characteristics of the CBG (n = 42) and loose bone grafting (n = 47) groups did not significantly differ. Fusion assessments indicated that significantly superior bone fusion rates were achieved at 1 year after surgery in the CBG group than in the loose bone grafting group (P = .04, χ test). However, the bone fusion rates of the 2 groups at 2 years after surgery did not significantly differ (P = .3). A nonsymptomatic surgical complication occurred in the CBG group when a spacer was inserted into the intervertebral space; specifically, the spacer slipped out of the right psoas muscle because a large quantity of compaction bone grafts disrupted the cage's pathway.ConclusionIn posterior lumbar interbody fusion surgeries, bone fusion was achieved more quickly with the CBG technique than with the conventional technique.AbbreviationsCBG, compaction bone graftingIBG, impaction bone graftingLBG, loose bone graftingPLIF, posterior lumbar interbody fusion.

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