AUTOLOGOUS BONE-GRAFTING IN STAGED SCOLIOSIS SURGERY - THE PATIENT ASBONE BANK

Study Design, A prospective clinical study in which autologous rib gra ft, harvested during the thoracotomy in staged scoliosis correction, i s stored within the patient for use during the second stage (posterior intrumentation and fusion). Objective, To determine whether the bone stored by this technique is biologically viable and microbiologically safe, Summary of Background Data. To the authors' knowledge, this meth od of storage of bone has never been described previously. Methods. Du ring the first operation, the excised rib was divided into 3-5 cm frag ments and stored in a sub-muscular plane adjacent to the posterior ele ments of the spine before closure. The graft was then retrieved at the second stage. Samples were sent for histologic and microbiologic exam ination before implantation. Results. On histologic examination, more than 50% of the osteocytes retained their basophilic staining, indicat ing that they were viable. In addition, osteoclastic activity was nota bly absent. There was no significant bacterial contamination of the sa mples. Clinically, all patients achieved satisfactory bone fusion. Con clusion, Homeostatic equilibrium in humans provides the ideal environm ent in which bone graft can be stored. There is no increased risk of i nfection, and the osteogenic potential of the graft is retained.