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back to DBM Case Studies Early Growth in Posterolateral Spine Fusion with the Use of Demineralized Bone Matrix (DBM)
History A 70-year-old woman presented with moderate lumbar scoliosis, a history of persistent severe low back pain and lumbar radiculopathy. MRI demonstrated L4-L5 grade I spondylolisthesis, prominent bony disc osteophyte complex at L3-L4-L5, and significant degenerative facet changes resulting in severe bilateral foraminal stenosis and some central canal stenosis.
Treatment After failure of conservative treatments, the patient underwent bilateral L3-L4-L5 posterolateral fusion, supplemented with L3-L4-L5 posterior instrumentation with pedicle screws. A posterior lumbar interbody fusion was impracticable due to significantly narrow disc spaces. The posterolateral fusion was performed using a total of 25cc of DBM granules (150µm to 800µm) soaked in autologous bone marrow aspirated from the patient’s iliac crest.
Postoperative Results and Outcome The postoperative course was uneventful. Neither generalized nor local adverse reactions were observed postoperatively. Follow-up radiographs were obtained at six weeks and five and a half months after the surgery. The six week AP views already showed clear evidence of bone growth in the right L3-L5 posterior lateral region (Fig. 1). At five and a half months, X-rays demonstrate an increase of fusion bone mass in the right posterior lateral region (Fig. 2). Further follow-up evaluation has been planned.
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Figure 1. 6 Weeks Postoperative: bone growth is already visible in the right posterior lateral region.
Figure 2. 5.5 Months Postoperative: AP views demonstrate an increase of fusion mass of the right posterior lateral region.
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