A new seven-year follow-up study of 53 patients provides new evidence that morcellized locally harvested autologous grafts can help surgeons achieve 360° spinal fusion in fracture dislocation of the thoracolumbar spine.
7-Year Follow-Up for Using Local Grafts in Fracture Repair
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Secondary#spinefusion#morselizedlocalgrafts#thoracolumbarfusion
The research, “Morcellized local grafts as cost effective option for interbody fusion in thoracolumbar fracture dislocation: Seven years follow up of 53 patients,” was published online in the May/June 2022 issue of the Journal of Orthopaedics.
“Traumatic fracture dislocation of the spine injury is essentially a three column injury that optimally needs surgical intervention to decompress, stabilize and fuse the spinal column,” the researchers wrote.
In their study, the research team evaluated the outcome of posterior and posterolateral decompression, instrumentation and 360° fusion after locally harvested autologous morselized grafts were used to treat traumatic fracture dislocation of thoracolumbar spine.
Fifty-three patients between the ages of 16 and 55 years were included in the study. All had experienced a single level fracture dislocation of thoracolumbar spine (D5-L5). Each patient underwent posterior and posterolateral decompression, posterior instrumentation and interbody as well as posterolateral fusion with the use of morcellized bone. Data was collected immediately after the surgery and then again 12 months and then yearly for a minimum of 7 years.
The majority of the patients were male, and the mean age was 31.15 ±9.64 years. Thoracolumbar dislocation most commonly occurred at the thoracolumbar junction (T10-L2). Thirty-six of the patients had complete neurological deficit while 16 had incomplete neurology.
At the one-year follow up, 48 patients had achieved osseous fusion and 5 patients had fibrous union. There were no implant failures reported until the last follow up. Change in kyphosis angle was not statistically significant.
“Morcellized locally harvested autologous grafts are sufficient to achieve 360° spinal fusion in fracture dislocation of thoracolumbar spine,” the researchers wrote.
Study authors included Kamran Farooque, Vijay Sharma, and Santana Kar, all of the Jai Prakash Narayan Centre in New Delhi, India.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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