The Barrow Innovation Center Case Series: Early Clinical Experience With Novel Low-Cost Techniques for Bone Graft Containment in the Posterolateral Fusion Bed

Department

neurosurgery

Document Type

Article

Abstract

Background: A frequently encountered problem during posterolateral fusion (PLF) is bone graft displacement from the posterolateral space during closure. Commercially available solutions to this problem are seldom used because of their exceptionally high cost. The purpose of this report is to describe 3 novel, low-cost techniques we developed for bone graft containment during PLF. Methods: Three low-cost bone graft containment techniques are described: rapid suture weave, makeshift bone bag, and cellulose rooftop. Early clinical experience with these techniques is reported for a 5-patient case series. Results: One or more of these bone graft containment techniques were used in 5 patients who underwent PLF. Rapid suture weave was the least expensive (<$5.00) but required the longest additional time to perform (20 minutes). Makeshift bone bag and cellulose rooftop cost approximately the same ($48.00 and $46.00, respectively); the makeshift bone bag took less additional time (3 minutes) but created a potential barrier between the bone graft and the host site, whereas the cellulose rooftop took slightly longer to perform (5 minutes) but permitted direct contact between the bone graft and host site. Conclusions: These 3 novel surgical techniques for bone graft containment in the posterolateral space add minimally to the cost and length of the procedure. Our early clinical experience suggests that these techniques are safe and effective. Additional clinical experience is warranted, and prospective data collection is ongoing.

Publication Date

2018

Publication Title

World Neurosurgery

ISSN

1878-8750

Volume

116

First Page

285

Last Page

295

Digital Object Identifier (DOI)

10.1016/j.wneu.2018.05.143

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