ANTERIOR FRESH-FROZEN STRUCTURAL ALLOGRAFTS IN THE THORACIC AND LUMBAR SPINE - DO THEY WORK IF COMBINED WITH POSTERIOR FUSION AND INSTRUMENTATION IN ADULT PATIENTS WITH KYPHOSIS OR ANTERIOR COLUMN DEFECTS
Kh. Bridwell et al., ANTERIOR FRESH-FROZEN STRUCTURAL ALLOGRAFTS IN THE THORACIC AND LUMBAR SPINE - DO THEY WORK IF COMBINED WITH POSTERIOR FUSION AND INSTRUMENTATION IN ADULT PATIENTS WITH KYPHOSIS OR ANTERIOR COLUMN DEFECTS, Spine (Philadelphia, Pa. 1976), 20(12), 1995, pp. 1410-1418
Study Design. This was a prospective study of 24 adult patients with k
yphosis or anterior column spinal defects treated with anterior fresh
frozen allograft for anterior column defects and posterior instrumenta
tion and autogenous grafting. Objectives. The objectives of the study
were to assess the effectiveness of the anterior allograft in maintain
ing sagittal correction and to assess anterior incorporation. Summary
of Background Date. Twenty-four patients were followed for a minimum o
f 2 years (range, 2 + 0-5 + 4 years). Methods. Upright radiographs wer
e analyzed before surgery, immediately after surgery, and at the final
follow-up examination to assess success of anterior fusion and mainte
nance of correction. A strict four-point grading system was used. Two
independent observers analyzed the radiographic results. Results. Only
two patients showed some collapse of their anterior allograft. The ot
her 22 patients maintained correction, attaining a Grade I or Grade II
fusion. Semiconstrained instrumentation was used posteriorly in the t
wo patients who had graft collapse. Conclusions. Anterior structural a
llograft worked effectively to maintain correction of kyphosis if comb
ined with posterior instrumentation and autogenous grafting. Rigid for
ms of posterior instrumentation were preferred.