Pedicle fat grafts for the prevention of scar in low-back surgery. A preliminary report on the first 92 cases.

Encouraged by the results of an experimental study on dogs, the authors performed pedicle fat grafts in 92 patients. The grafts were used in the following groups of patients: following primary disc removal (37 cases); following scar removal in the multiply operated back with definite root findings (37 cases); in patients with spondylolisthesis who had had prior decompressions but developed fifth lumbar nerve root pain after lateral fusion (6 cases); in three patients with spondylolisthesis and simple decompression; in nine patients with spinal stenosis. Pedicle fat grafts were obtained from the subcutaneous layer of fat of the low back in 85 patients and from the buttocks in seven patients. The grafts were brought through openings in the fascia and muscle and were used to cover the dural sac as well as the margins of the nerve root. They were held in position by a fine suture of silk. The results after a minimum follow-up of 1 year and a maximum of 4 years have been excellent or good in 66 percent of the patients who have had lateral fusion with resultant L5 root compression, in 99 percent of patients with spondylolisthesis and decompression only, and in 66 percent of patients with spinal stenosis. The results in the other two groups compare favorably with those reported in the literature.