Background and Objectives: Posterior lumbar interbody fusion (PLIF) plays a crucial role in addressing various spinal disorders. The success of PLIF is contingent upon achieving bone fusion, as failure can lead to adverse clinical outcomes. Demineralized bone matrix (DBM) has emerged as a promising solution for promoting fusion due to its unique combination of osteoinductive and osteoconductive properties. This study aims to compare the effectiveness of three distinct DBMs (Exfuse^®, Bongener^®, and Bonfuse^®) in achieving fusion rates in PLIF surgery. Materials and Methods: A retrospective review was conducted on 236 consecutive patients undergoing PLIF between September 2016 and February 2019. Patients over 50 years old with degenerative lumbar disease, receiving DBM, and following up for more than 12 months after surgery were included. Fusion was evaluated using the Bridwell grading system. Bridwell grades 1 and 2 were defined as ‘fusion’, while grades 3 and 4 were considered ‘non-fusion.’ Clinical outcomes were assessed using visual analog scale (VAS) scores for pain, the Oswestry disability index (ODI), and the European quality of life-5 (EQ-5D). Results: Fusion rates were 88.3% for Exfuse, 94.3% for Bongener, and 87.7% for Bonfuse, with no significant differences. All groups exhibited significant improvement in clinical outcomes at 12 months after surgery, but no significant differences were observed among the three groups. Conclusions: There were no significant differences in fusion rates and clinical outcomes among Exfuse, Bongener, and Bonfuse in PLIF surgery.

Background and Objectives: Lumbar decompression with fusion surgery is an effective treatment for spinal stenosis, but critical postoperative hematoma is a concern. Bone wax has been widely used to control bone bleeding but it has some drawbacks. This study aimed to evaluate the efficacy of Tableau wax, a bioabsorbable hemostatic material, in patients undergoing spinal fusion surgery through a pilot study design. Materials and Methods: A total of 31 patients were enrolled in this single-surgeon, single-institution study. The participants underwent transforaminal lumbar interbody fusion surgery and were randomly assigned to the control group (Bone wax) or test group (Tableau wax). Demographic data, pre- and post-operative hemoglobin levels, blood loss volume, surgical time, Oswestry Disability Index, and EQ-5D scores were recorded. Results: The study showed no significant difference in preoperative and postoperative hemoglobin levels, Oswestry Disability Index, and EQ-5D scores between the groups. However, the Tableau wax group had a significantly lower reduction in hemoglobin levels (1.3 ± 1.0 g/dL) and blood loss (438.2 mL) compared to the Bone wax group (2.2 ± 0.9 g/dL and 663.1 mL, respectively; p = 0.018 and p = 0.022).

Background/Objectives: Transforaminal lumbar interbody fusion (TLIF) and lateral lumbar interbody fusion (LLIF) are widely utilized techniques for degenerative lumbar diseases. This study compared radiological and clinical outcomes of LLIF and TLIF in patients undergoing lumbar fusion. Methods: This non-randomized prospective observational study enrolled 117 patients (LLIF: n = 17; TLIF: n = 100), with an inherent imbalance in group sizes, who underwent one- or two-level lumbar interbody fusion. Primary outcome was segmental lordotic angle (SLA) at the operated level. Secondary outcomes included disc height, lumbar lordotic angle, sagittal vertical axis, and patient-reported outcomes. Assessments were conducted at baseline, 3, 6, 12, and 24 months. Linear mixed models analyzed longitudinal data. Results: Mean SLA improvement was not significantly different between the groups (LLIF: 3.04° vs. TLIF: 3.18°, p = 0.782). No significant differences were observed for disc height (p = 0.518), lumbar lordotic angle (p = 0.718), or sagittal vertical axis (p = 0.866). Patient-reported outcomes improved significantly in both groups. Linear mixed model analysis revealed no significant between-group effects for Oswestry Disability Index (p = 0.335) or low back pain (p = 0.069). TLIF showed higher rates of dural tears and wound complications, while LLIF had more sympathetic chain injuries and transient psoas weakness. Overall complication rates were comparable (p > 0.05). Conclusions: TLIF and LLIF demonstrate comparable radiographic and clinical outcomes at 24-month follow-up. Surgical technique selection should be individualized based on patient-specific anatomical and clinical factors, considering distinct approach-specific complication patterns.