THE USE OF BONE ALLOGRAFTS IN THE SPINE

Bone allografts are commonly used in spinal surgery, Structural allogr afts placed anteriorly in the spine may be used as interbody grafts or as strut grafts spanning multiple segments, Posterior allografts are used to supplement autologous bone for spinal fusions in patients who lack sufficient host bone and to avoid significant donor site morbidit y, In this paper the authors review their experience with allograft bo ne in spine surgery and the results reported in the literature, In the anterior cervical spine, interbody allografts have been used most suc cessfully in single-level fusions, For thoracolumbar deformity, poster ior allograft with instrumentation gives satisfactory results in pedia tric patients but yields inferior results in adults unless it is combi ned with an anterior fusion, Fresh-frozen allograft bone has been show n to have higher fusion rates than freeze-dried allograft; ethylene ox ide-sterilized allograft has shown uniformly poor results, Structural allografts have been useful for thoracolumbar deformity in both interb ody and strut-grafting procedures, In the lumbar spine, allograft has a limited role in posterolateral fusion, For anterior interbody fusion s, structural allografts, such as femoral ring allografts, have been u sed successfully to maintain intervertebral distraction, despite delay ed incorporation, Successful use of allograft bone in the spine is dep endent on the type of allograft bone used, its anatomic site of fusion , and the age of the patient.