• Michael A Bohl, David S Xu, Lorin Daniels, Steve W Chang, Peter Nakaji, Randall W Porter, and U Kumar Kakarla.
• Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• World Neurosurg. 2018 Aug 1; 116: 285-295.

BackgroundA frequently encountered problem during posterolateral fusion (PLF) is bone graft displacement from the posterolateral space during closure. Commercially available solutions to this problem are seldom used because of their exceptionally high cost. The purpose of this report is to describe 3 novel, low-cost techniques we developed for bone graft containment during PLF.MethodsThree low-cost bone graft containment techniques are described: rapid suture weave, makeshift bone bag, and cellulose rooftop. Early clinical experience with these techniques is reported for a 5-patient case series.ResultsOne or more of these bone graft containment techniques were used in 5 patients who underwent PLF. Rapid suture weave was the least expensive (<$5.00) but required the longest additional time to perform (20 minutes). Makeshift bone bag and cellulose rooftop cost approximately the same ($48.00 and $46.00, respectively); the makeshift bone bag took less additional time (3 minutes) but created a potential barrier between the bone graft and the host site, whereas the cellulose rooftop took slightly longer to perform (5 minutes) but permitted direct contact between the bone graft and host site.ConclusionsThese 3 novel surgical techniques for bone graft containment in the posterolateral space add minimally to the cost and length of the procedure. Our early clinical experience suggests that these techniques are safe and effective. Additional clinical experience is warranted, and prospective data collection is ongoing.Copyright © 2018 Elsevier Inc. All rights reserved.

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