Outcomes of Posterior Fusion with Autologous Bone Graft in Lumbosacral Spondylolisthesis: A Multicenter Study in Bangladesh

ABSTRACT Background: Lumbosacral spondylolisthesis often requires surgical fusion to stabilize the spine, reduce pain, and restore function. Objective: This study assesses the outcomes of posterior fusion with autologous bone grafting in patients with lumbosacral spondylolisthesis across multiple tertiary hospitals in Bangladesh. Method: A prospective study was conducted on 358 patients undergoing posterior fusion with autologous bone grafts between June 2019 and June 2022. Clinical and radiological outcomes were measured at 3-, 12-, and 24-months post-surgical period. Results: At 24 months, 294 patients (82.1%) achieved successful fusion, while 273 (76.3%) reported substantial pain reduction (≥50% decrease in baseline scores). Functional mobility improved in 243 patients (67.9%), with an average increase of 32.5 points on the Oswestry Disability Index. Complications included donor site pain in 54 patients (15.1%), managed conservatively, and graft resorption in 10 patients (2.8%). Postoperative infections were documented in 36 patients (10.1%), primarily minor, with all resolving following antibiotic treatment. Outcomes varied by age, with those under 50 showing a 10% higher rate of fusion success compared to older patients (86.5% vs. 76.5%). Nutritional status also influenced recovery, with undernourished patients exhibiting a 15% lower improvement in mobility scores compared to adequately nourished patients. Conclusion: Posterior fusion with autologous bone grafting offers effective treatment for lumbosacral spondylolisthesis in Bangladesh, demonstrating high fusion rates and functional gains. These findings support its broader application in resource-limited settings.