In an anterior interbody fusion, the grafted bone should be placed between intact subchondral bones of the adjacent vertebrae for achieving mechanical stability. This long graft bone causes more discomfort of donor site and requires more fusion
segment
and longer time for solid fusion. As the development of the spine instrument, it provides strong mechanical stability to the grafted site and enables to use short graft acrossing the inferior subchondral bone of the superior vertebra and the
mid-portion
of the injured vertebra with normal bony structure. This techinque is, especially, useful to the treatment for Denis type B bursting fractures.
Twenty-six patients with Denis type B bursting fractures, treated by anterior interbody fusion with instrument at Ewha Womans University Hospital from 1988 to 1992, were reviewed in an attempt to analyze the results regarding to the length of the
graft.
The mean follow-up was 16 months.
The patients were classified into two groups. One group underwent operation using long graft crossing inferior subchondral bone of superior vertebra and superior subchondral bone of inferior vertebra. Another group underwent operation using short
graft
crossing inferior subchondral bone of superior vertebra. Fourteen patients underwent operation with long graft, twelve patients with short graft. The fusion time averaged 3.1°in long graft group, 5.1°in short graft group. But there was no
statistical
significance in the loss of the reduction angle.
These data suggest that the anterior interbody fusion using short bone graft with instrument is the recomendable procedure for Denis type B bursting fracture.
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