Volumetric change in interbody bone graft after posterior lumbar interbody fusion (PLIF): a prospective study

Abstract

Purpose: The purpose of this study is to quantify the change in the volume of the interbody bone graft after the PLIF and monitor the change over time for subsequent analysis.

Methods: The 114 cases were selected as the subjects of this study. The observation period was for 5 years following the surgery. The volume of the bone graft in the interbody space was calculated by summing up the cross-sectional area of the bone graft on each axial image multiplied by the height (2 mm) (the volume of the two cages was excluded). The volume ratio (%) = (bone graft volume)/(total volume of the interbody space - cage volume) was used for the purpose of evaluation.

Results: The volumetric change of the bone graft was 51 % (3 months), 53 % (6 months), 54 % (1 year), 55 % (2 years), 59 % (3 years), 62 % (4 years), and 72 % (5 years), indicating a continued increase up to the 5-year mark. In particular, a significant increase was observed from the second year as compared with the previous years' result. Additionally, the volumetric increase from the second year to the fifth year was significantly higher than that before the second year.

Conclusions: The post-PLIF volumes of interbody bone grafts exhibited increases particularly from the second to fifth years after the procedure. Even the elderly and those with poor bone qualities can expect to have volumetric increases over time. Sufficient interbody space should be secured for accommodating bone grafts by intraoperative reduction, wherever possible.