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Two to Eight Year Follow-Up of Structural Allograft in Lumbar Spine Surgery

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Abstract from the SRS 2001 Annual Meeting

Melanie B. Kinchen, MD
Mustafa Ozdemir, MD
David Cohen, MD
Khalid Kebaish, MD
John Kostuik, MD

Johns Hopkins Hospital, Baltimore, Maryland, USA

PURPOSE: To assess the bony incorporation and long term success rates of structural allograft in lumbar spine surgery.

METHODS: A retrospective review of 238 patients receiving structural femoral ring allograft augmented with autograft and/or demineralized bone matrix was completed. Diagnoses included failed back syndrome, degenerative disc disease, kyphoscoliosis, spondylolisthesis, and pseudarthrosis. Patients were instrumented anteriorly, posteriorly, or in combination at the discretion of the surgeon. Fusion rates were assessed radiographically by 3 independent spine surgeons using the Bridwell and Lenke grading system for allograft incorporation into host vertebrae. Minimum and maximum follow up was from 2-8 years.

RESULTS: Of the 238 patients, 98% showed evidence of incorporation at 2 years. There was no statistical difference in interobserver reliability. There was no significant change in alignment or evidence of graft subsidence at up to eight years.

CONCLUSIONS: Structural femoral ring allograft augmented with demineralized bone matrix and autograft is effective in regaining structural support and alignment in patients with failed back syndrome and deformity. Excellent graft incorporation at 2 years was noted. This effect was maintained over time with no evidence of subsidence or pseudarthrosis at up to eight years. This is the largest series with the longest follow-up period currently reported in the literature.

Updated on: 12/10/09