Lumbosacral distraction spondylodesis with autologous bone graft together with posterolateral fusion

We supplement posterolateral fusion with medial interspinal distraction spondylodesis to attain decompression in addition to fixation in the dorsal part of the two lower lumbar motion segments. An exactly fitted corticospongiosa bone graft from the spina iliaca posterior is wedged between the spinal processes L4 and S1 under distraction with maximal kyphosis of the lumbar spine; metallic implants are not used. The graft maintains the distraction until the posterolateral fusion band is fixed. Furthermore, a third fusion band is thus made. Indication, technique, and postoperative treatment are described. The outcome and durability of the distraction are checked with a standardized measurement procedure for motion segments L4 to S1.