A Comparative Study of Autograft and Tutoplast Processed Allograft in Posterolateral Lumbar Spine Fusion

Kwak, Ho Yon

Abstract

Fresh autogenous bone is regarded as the most effective biologic resource for repair or reconstruction of the skeletal system. Disadvantages, however, are related to doner site morbidity and include the risk of wound infection, increased blood loss, prolonged anesthesia time, and additional postoperative discomfort. To avoid the disadvantages of fresh autogenous bone graft, we started to use Tutoplast processed allograft to the operation of spinal disorders of elderly patients. The purpose of this article is to evaluate the incorporation ability of the allograft and possibility of it for suitable substitutes for autogenous bone graft. From March 1995 to October 1996, twenty-seven elderly patients at Nowon Eulji hospital received operation for mainly stenotic lumbar spine disorders. Surgical procedures to all patients consisted of massive decompression, posterior instrumentation and bilateral posterolateral fusion and were done by same surgeon. The types of bone graft used for 54 cases of posterolateral lumbar spine fusion included 40 cases of autograft alone, 8 cases of Tutoplast processed allograft alone and 6 cases of a combination of autograft and the allograft. Of the 40 cases using the autograft only, 37 cases(92.5%) showed good bone incorporation and fusion mass formation but all eight cases using only Tutoplast processed allograft showed complete resorption within postoperative three to five months. Of the six cases using mixture of autograft and the allograft, three had incomplete but largely appropriate bone mass formation. There was great statistical difference(p<0.001) between autograft and the allograft in bone incorporation ability and concluded that Tutoplast processed allograft was not appropriate for the purpose of solid bone mass formation on posterolateral lumbar spine fusion.