Corresponding Author

Alaa ElBanna, MD.

Authors ORCID


Subject Area

Degenerative, Lumbosacral spine, Surgical techniques

Document Type

Original Study


Background Data: The autogenous iliac crest bone graft (ICBG), which is regarded as the preferred graft for spinal fusion, has difficulties and limitations that are being addressed by the development of novel bone alternatives. Due to the increased mesenchymal stem cells (MSC) concentration, the mixture of autologous bone marrow aspirate and local bone from the decompression process results in a substance that is osteoconductive and may be more osteogenic and osteoinductive than ICBG.

Purpose: This study reports the clinical and radiological outcomes of single-level posterior lumbar interbody fusion (PLIF) for lumbar stenosis and instabilities using local bone graft with and without bone marrow aspirate.

Study Design: This is a prospective controlled randomized trial.

Patients and Methods: The study population included patients with lumbar instability, lumbar disc disease, or lumbar canal stenosis indicated for single-level PLIF. In total, 64 patients were divided into two groups: Group I included 32 patients treated with single-level PLIF using local bone graft augmented with bone marrow aspirate (BMA); Group II included 32 patients treated with single-level PLIF using local bone graft without BMA augmentation. Both groups were followed for at least 12 months. Clinical evaluation was done according to the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Radiological judgment at the end of follow-up was done using Brantigan, Steffee, and Fraser (BSF) criteria.

Results: There was excellent agreement among the three observers (86%). Group I (PLIF with BMA) has shown superior results regarding clinical and radiological parameters compared with Group II (PLIF without BMA). However, the results were not statistically significant.

Conclusion: BMA may be a potentially efficient cheap bone substitute in enhancing spinal fusion. However, further studies are still recommended to determine its precise efficacy.


Lumbar spine, Degenerative spine, Bone marrow aspirate, Posterior lumbar interbody fusion