Results of Local Bone and Allograft Mixed Grafting in Selective Thoracic Fusion for Adolescent Idiopathic Scoliosis(AIS)

Kim, Won Joong; Suk, Se Il; Kim, Jin Hyok; Lee, Sang Min; Lee, Chang Seop; Hwang, Chang Hoon

Abstract

STUDY DESIGN: A retrospective study.
OBJECTIVES
To determine the necessity of autogenous iliac grafting in selective thoracic fusion with segmental pedicle screw fixation in AIS SUMMARY OF BACKGROUND DATA: Though autografting is the gold standard for scoliosis surgeries, the frequency of complications makes this procedure a problem. In AIS patients subject to selective thoracic fusion, segmental pedicle screw instrumentation enabling a rigid fixation may offer satisfactory fusion with mixed graft of local bone and allograft, negating the need of autogenous cancellous grafting.
METHODS
Fifty-eight AIS patients subjected to selective thoracic fusion by segmental pedicle screw fixation were analyzed. Group I consisted of 29 patients with autogenous iliac cancellous graft. Group II consisted of 29 cases with mixed graft of local bone and commercial allograft. The results were graded into union, probable union, probable nonunion and nonunion by the clinical results and radiological results after minimum follow up of 1 year.
RESULTS
In group I, the fusion status was union in 21 and probable union in 8 patients with no probable nonunion or nonunions. In Group II, the fusion status was union in 13 and probable union in 16 cases with no probable nonunion or nonunions. There was no significant difference in results between two groups
CONCLUSIONS
In AIS patients subject to selective thoracic fusion by segmental pedicle screw fixation, local bone and allograft mixed graft may be used as an alternative to autogenous iliac bone