Related Experiment Video
Updated: Aug 12, 2026
11:30
Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
Published on: July 25, 2025
Lumbar posterolateral fusion with biphasic calcium phosphate ceramic
S Fujibayashi1, J Shikata, C Tanaka
1Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-9507, Japan. shfuji@kuhp.kyoto-u.ac.jp
Journal of Spinal Disorders
|June 5, 2001
Summary
Hydroxyapatite and beta-tricalcium phosphate (HAP-TCP) ceramic implants combined with rigid instrumentation offer a safe and effective alternative for lumbar posterolateral fusion (PLF). This bone graft substitute demonstrated solid fusion and clinical improvement in patients, reducing donor-site complications.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Spinal Fusion Techniques
Background:
- Autogenous iliac bone graft is the gold standard for spinal fusion but carries risks of donor-site morbidity.
- Alternative bone graft substitutes are sought to mitigate these complications.
- Biphasic calcium phosphate ceramics offer osteoconductive properties for bone regeneration.
Purpose of the Study:
- To evaluate the clinical, radiographic, and histologic outcomes of using a biphasic calcium phosphate ceramic (HAP-TCP) as a bone graft substitute in lumbar posterolateral fusion (PLF).
- To assess the safety and efficacy of HAP-TCP in combination with rigid instrumentation for spinal fusion.
- To compare the fusion characteristics of HAP-TCP with conventional autogenous bone graft.
Main Methods:
- Retrospective observational study of 32 patients undergoing single-level lumbar PLF with instrumentation.
- Locally harvested bone mixed with HAP-TCP granules and sticks used as graft material.
- Clinical assessment, radiographic evaluation, and histologic analysis of biopsy specimens.
Main Results:
- No instrument loosening or breakage observed during a minimum 26-month follow-up.
- Solid fusion confirmed histologically in three biopsy specimens.
- Clinical improvement in 31 out of 32 patients.
- Partial graft resorption noted radiographically in 75% of cases, with inferior image quality compared to autogenous bone.
Conclusions:
- HAP-TCP combined with rigid instrumentation is a safe and effective alternative for lumbar PLF.
- Histologic analysis confirmed excellent bone incorporation around HAP-TCP granules.
- While the fusion mass may be smaller than with autogenous bone, the procedure reduces donor-site complications.
