Radiographic and patient-based outcome analysis of different bone-grafting techniques in the surgical treatment of idiopathic scoliosis with a minimum 4-year follow-up: allograft versus autograft/allograft combination Journal Article


Authors: Lansford, Todd J; Burton, Douglas C.; Asher, Marc A.; Lai, Sue Min
Article Title: Radiographic and patient-based outcome analysis of different bone-grafting techniques in the surgical treatment of idiopathic scoliosis with a minimum 4-year follow-up: allograft versus autograft/allograft combination
Alternate Title: The spine journal: official journal of the North American Spine Society
Abstract: BACKGROUND CONTEXT: Autograft and allograft have been equally successful in achieving arthrodesis, but whether there is any difference in their effect on patient outcome, especially early, has not been determined. PURPOSE: To determine if autograft in addition to allograft is associated with decreased healing period pain, increased early function, or both. STUDY DESIGN: This is a retrospective comparative case series. PATIENT SAMPLE: A sample of 47 patients, 20 years or younger with adolescent idiopathic scoliosis treated by the same surgeon at the same institution using third-generation segmental spinal instrumentation and arthrodesis. OUTCOME MEASURE: Function and pain were quantified at periodic intervals using the Scoliosis Research Society (SRS) health-related quality of life (HRQoL) questionnaire. Clinical and radiographic follow-ups were completed. METHODS: Freeze-dried corticocancellous allograft (AL) was used in 26 patients and allograft plus iliac crest autograft (AL-AU) in 21 patients. Radiographs and outcome measures, including SRS-24 or SRS-22 HRQoL questionnaires, were obtained preoperatively and at intervals with a 4-year follow-up available for 92% (25/26) of AL patients and 90% (19/21) of AL-AU patients. RESULTS: There were no differences between the AL and AL-AU groups' ages, curve patterns, and complications. Neither group had a major complication or pseudoarthrosis. There were no main curve size differences at any interval. Pain scores were similar at all intervals: AL/AL-AU preoperative, 4.1/4.0; early follow-up (<1 year), 3.7/4.1; midterm follow-up (1-2 years), 4.4/4.6; and late follow-up (>3 years), 4.1/4.0. Function scores were also similar at all intervals: AL/AL-AU preoperative, 4.7/4.6; early follow-up, 4.2/4.3; midterm follow-up, 4.9/4.9; and late follow-up, 4.5/4.4. CONCLUSIONS: The addition of autograft to allograft did not result in decreased pain or increased function at any time interval up to 4 years. We conclude that the addition of iliac crest autograft does not result in any advantage over freeze-dried allograft alone in the treatment of adolescent idiopathic scoliosis.
Journal Title: The spine journal : official journal of the North American Spine Society
Volume: 13
Issue: 5
ISSN: 1878-1632
Publisher: Elsevier Science Inc.  
Date Published: 2013-05
Start Page: 523
End Page: 529
Language: English
Copyright Statement: Copyright © 2013 Elsevier Inc. All rights reserved.
DOI/URL:
Identifier: PMID: 23478238
Notes: Comment in Bone grafting techniques in idiopathic scoliosis: a confirmation that allograft is as good as autograft but dispels the purported pain associated with the iliac crest bone graft harvest. [Spine J. 2013]