• Jong-Beom Park, Jae Hyuk Yang, Dong-Gune Chang, Se-Il Suk, Seung-Woo Suh, Gang-Un Kim, Jung Yun Choi, Jun-Yeong Seo, Hyung-Youl Park, Sang-Il Kim, Young-Hoon Kim, and Kee-Yong Ha.
• Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
• World Neurosurg. 2020 Jul 1; 139: e286-e292.

ObjectiveTo compare the radiologic union rates between autogenous iliac crest bone graft (ICBG) and local bone graft in 1- to 3-level lumbar fusion.MethodsWe reviewed 178 consecutive patients who underwent 1- to 3-level lumbar fusion surgery because of lumbar spinal stenosis. Fusion status of the anterior or posterior column was evaluated by plain radiographs obtained at 24 months postoperatively. If at least either the anterior or posterior column was fused, that segment was regarded as having achieved fusion and was termed segment union. The definition of overall union was achieving union of all segments in a single patient.ResultsFor each ICBG group and local bone graft group, fusion rate of the anterior and posterior column, and rate of the segments and overall union at postoperative 2 years were not different between the groups, regardless of surgery level. In the overall union rate according to the fusion level, the ICBG group showed constant overall fusion rate according to the fusion level (i.e., 96.9%, 96.9%, and 93.1% for 1-, 2-, and 3-level fusion), but tended to decrease with increasing level in the local bone graft group (100%, 95.8%, and 85.7% for 1-, 2-, and 3-level fusion, respectively) without statistically significant differences.ConclusionsThe union rate of 3-level fusion was not inferior to those of 1- or 2-level fusion in both ICBG and local bone graft patients. Local bone graft could be regarded as an adequate option for not only 1- or 2-level lumbar fusion but also 3-level lumbar fusion surgery.Copyright © 2020 Elsevier Inc. All rights reserved.

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