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Updated: Jun 22, 2026
Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion
Published on: June 6, 2025
Beta tricalcium phosphate: observation of use in 100 posterolateral lumbar instrumented fusions
1Neurological Surgery, the Albert Einstein College of Medicine, Bronx, NY, USA. dch3@columbia.edu
Background:
Beta tricalcium phosphate (B-TCP) is increasingly used to supplement lamina autograft to perform posterolateral lumbar-instrumented arthrodesis.
Purpose:
To determine the radiographic arthrodesis and pseudarthrosis rates after multisegment lumbar laminectomies and one- or two-segment posterolateral instrumented fusion using lamina autograft and an artificial bone graft expander B-TCP (Vitoss; Orthovita, Malvern, PA, USA).
Study Design/Setting:
To document radiographic arthrodesis/pseudarthrosis rates using lamina autograft and B-TCP.
Patient Sample:
One hundred patients with lumbar spinal stenosis underwent multisegment laminectomies (average 3.6 segments) and one- (78 patients) or two- (22 patients) segment posterolateral instrumented arthrodesis.
Outcome Measures:
Two-year postoperative outcomes were assessed using Short-Form 36 questionnaires.
Methods:
The arthrodesis mass consisted of lamina autograft and B-TCP. Two independent neuroradiologists, using both dynamic X-rays and 2D-CT studies performed 3, 4.5, 6, and up to 12 months postoperatively, documented radiographic arthrodesis progression.
Results:
One-segment arthrodesis was performed in 79 patients; 74 (93.7%) were radiographically fused "early" (6.5 postoperative months), 2 (2.5%) fused "late" (6.5-12 months), and 3 (3.8%) exhibited pseudarthrosis. Two-segment arthrodesis was performed in 21 patients; 14 (66.7%) radiographically fused "early," 5 (23.8%) fused "late," and 2 (9.5%) exhibited pseudarthrosis. Although chi-square analyses revealed a significant increase in the number of "late" radiographic fusions occurring for patients undergoing two-level arthrodesis, no significant difference in radiographic pseudarthrosis rates was noted between the two patient populations. In both groups, Short-Form 36 questionnaires revealed nearly comparable maximal improvement on seven of eight Health Scales by the second postoperative year.
Conclusions:
At 6.5 months after multisegment lumbar laminectomies with posterolateral instrumented lumbar arthrodesis using lamina autograft/B-TCP, more one-segment (93.7%) versus two-segment (66.7%) radiographic arthrodesis occurred. By 1 year after operation, there was no significant difference in fusion rates between one- and two-segment radiographic arthrodeses.