Functional and Fusion Outcomes of Local Autogenous Bone Grafting in Lumbar Spondylolisthesis

Abstract

Background: Low-grade isthmic and degenerative lumbar spondylolisthesis are important causes of back pain and disability, often requiring surgical fusion after failed conservative treatment. Although iliac crest autograft is the traditional standard for achieving fusion, donor site morbidity has led to increasing use of local autogenous bone from decompression as an alternative. Therefore, this study aimed to evaluate the functional and radiological fusion outcomes of local autogenous bone grafting in lumbar spondylolisthesis.

Methods: This retrospective study was conducted in the Department of Orthopaedic Surgery, IBN Sina Medical College Hospital, Dhaka, Bangladesh, from April 2021 to April 2026, including 38 adults with Meyerding grade I–III lumbar spondylolisthesis treated by posterior decompression and pedicle screw–rod fixation with local autogenous bone graft. Data covered demographics, clinical and radiological findings, with follow?up at 1, 3, 6, and 12 months; outcomes were assessed by VAS, ODI, Bridwell fusion grading, and Modified Lee’s criteria, with all patients receiving early mobilization, physiotherapy, and brace?supported rehabilitation.

Results: The study included 38 patients (mean age 49.3 ± 14.0 years; 55.3% female), mainly 40–59 years (52.6%) with Grade II disease (73.7%) at L4–L5 (50.0%). Significant improvement was seen in VAS (8.1→1.6) and ODI (50.2%→15.8%) (p<0.001). Good-to-excellent outcomes were 84.2%, fusion success 97.4%, and complication rate 5.3% (pseudoarthrosis 2.6%, ASD 2.6%).

Conclusion: Local autogenous bone grafting in lumbar spondylolisthesis is an effective technique, providing reliable functional improvement, high fusion rates, and a low complication profile.