Incomplete incorporation of morselized and impacted autologous bone graft - A histological study in 4 intracorporally grafted lumbar fractures

Morselized and impacted bone allografts are used successfully in hip and kn ee revisions, but experiments using bone chambers indicate that impaction a ctually can delay ingrowth of new bone into a graft. To understand the remo deling and incorporation process of morselized and impacted grafts, we stud ied the incorporation of morselized impacted autografts in lumbar fractures histologically. 4 patients were operated on for Th XII-LI fractures. The fractures were sta bilized by VSP plates and transpedicular screws in the vertebrae above and below the fractured one. Autologous bone graft was packed into the fracture d vertebral body through one of the pedicles. After 18-20 months, the plate s were removed and biopsies were obtained from various locations in the fra ctured vertebra. All fractures were at this time clinically and radiographi cally healed. Histologically, in all cases, large areas of the autograft in the vertebral body were unvascularized and partially or entirely necrotic. As with morselized bone in hip revisions, evaluation of graft incorporatio n requires histological examination. Full osseous incorporation of a graft is not always necessary for a good clinical result.