Autogenic versus allogenic bone grafts in anterior lumbar interbody fusion

Between 1987 and 1993, 94 consecutive patients with painful spondylolisthes is underwent combined anterior and posterior fusion, The average age at ope ration was 40 years (range, 16-65 years). Posterior fusion was performed in all patients using pedicle screw systems, and anterior fusion was accompli shed with autogenic or allogenic bone grafts. Patients retrospectively were assigned to two groups. In Group 1, anterior fusion was performed with aut ogenic bone grafts harvested from the iliac crest (n = 65; 146 segments) an d in Group 2 allogenic bone grafts were taken from femoral heads (n = 39; 8 6 segments). The incidence of pseudarthrosis was evaluated on lateral tomog rams 24 months after surgery, The mean clinical followup time was 4 years ( range, 3-8 years). Pseudarthrosis was found in seven fused levels (3%) mana ged with autogenic bone grafts (Group 1) and in seven patients (8%) managed with allogenic bone grafts (Group 2). This incidence of pseudarthrosis was not significantly different between the two groups, Considering the possib le complications associated with harvesting iliac crest bone, the use of al logenic bone appears justified.