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Clinical and radiographic outcomes of the treatment of adolescent idiopathic scoliosis with segmental pedicle screws and combined local autograft and allograft bone for spinal fusion: a retrospective case series

DOI: 10.1186/1471-2474-11-159

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Abstract:

A combination of in situ local autograft bone and freeze-dried cancellous allograft blocks were used in 50 consecutive patients with adolescent idiopathic scoliosis treated by posterior fusion and Moss Miami pedicle screw instrumentation. Results were assessed clinically and radiographically and quality of life and functional outcome was evaluated by administration of a Chinese version of the SRS-22 survey.There were 41 female and 9 male patients included for analysis with an average age of 14.7 years (range, 12-17). All patients had a minimum follow-up of 18 months (range, 18 to 40 months). The average preoperative Cobb angle was 49.8° (range, 40° to 86°). The average number of levels fused was 9.8 (range, 6-15). Patients had a minimum postoperative follow-up of 18 months. At final follow-up, the average Cobb angle correction was 77.8% (range, 43.4 to 92.5%). There was no obvious loss in the correction, and the average loss of correction was 1.1° (range, 0° to 4°). There was no pseudarthrosis and no major complications.In situ autograft bone combined with allograft bone may be a promising method enhances spinal fusion in AIS treated with pedicle screw placement. By eliminating the need for iliac crest bone harvesting, significant morbidity may be avoided.The iliac crest is considered the best source of autograft bone for procedures treating bone nonunion, spinal fusion, and specifically posterior spinal fusion in corrective surgery for adolescent idiopathic scoliosis (AIS). However, studies have reported numerous complications associated with harvesting iliac crest bone including bleeding, infection, gait disturbance, neurological injury, fracture, and persistent donor site pain, with an incidence ranging from 24% to 29% [1-3]. The high morbidity of iliac crest bone graft harvesting has limited its application. Allograft bone has the advantages of adequate supply and variety of type, and reports indicate that allograft bone is a suitable alternative to autogenous b

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