Intertransverse Process Lumbar Arthrodesis with Autogenous Bone Graft

Fifty-eight patients with a variety of causes of chronic low back pain underwent posterolateral intertransverse process lumbar arthrodesis utilizing autologous iliac bone graft. The overall success rate of achieving fusion was 92%. Most of the failures occurred at the L4-L5 level. The economic and functional improvement as a result of this operation was between 70% and 80%, indicating that achievement of lumbar arthrodesis does not necessarily mean a successful surgical result. Overall improvement did not correlate specifically with levels of fusion or with performance of a laminectomy, but a history of prior low back surgery significantly lowered the success rate, regardless of achievement of a solid arthrodesis. Persisting discomfort at the iliac crest bone graft donor site somewhat lowered the overall improvement rate. Intertransverse process lumbar arthrodesis appears to be a highly satisfactory and perhaps a superior method of achieving lumbar fusion, when arthrodesis is indicated.