STUDY DESIGN: This was a prospective study of 24 adult patients with kyphosis or anterior column spinal defects treated with anterior fresh frozen allograft for anterior column defects and posterior instrumentation and autogenous grafting. OBJECTIVES: The objectives of the study were to assess the effectiveness of the anterior allograft in maintaining sagittal correction and to assess anterior incorporation. SUMMARY OF BACKGROUND DATA: Twenty-four patients were followed for a minimum of 2 years (range, 2 + 0-5 + 4 years). METHODS: Upright radiographs were analyzed before surgery, immediately after surgery, and at the final follow-up examination to assess success of anterior fusion and maintenance 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 other 22 patients maintained correction, attaining a Grade I or Grade II fusion. Semiconstrained instrumentation ws used posteriorly in the two patients who had graft collapse. CONCLUSIONS: Anterior structural allograft worked effectively to maintain correction of kyphosis if combined with posterior instrumentation and autogenous grafting. Rigid forms of posterior instrumentation were preferred.
STUDY DESIGN: This was a prospective study of 24 adult patients with kyphosis or anterior column spinal defects treated with anterior fresh frozen allograft for anterior column defects and posterior instrumentation and autogenous grafting. OBJECTIVES: The objectives of the study were to assess the effectiveness of the anterior allograft in maintaining sagittal correction and to assess anterior incorporation. SUMMARY OF BACKGROUND DATA: Twenty-four patients were followed for a minimum of 2 years (range, 2 + 0-5 + 4 years). METHODS: Upright radiographs were analyzed before surgery, immediately after surgery, and at the final follow-up examination to assess success of anterior fusion and maintenance 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 other 22 patients maintained correction, attaining a Grade I or Grade II fusion. Semiconstrained instrumentation ws used posteriorly in the two patients who had graft collapse. CONCLUSIONS: Anterior structural allograft worked effectively to maintain correction of kyphosis if combined with posterior instrumentation and autogenous grafting. Rigid forms of posterior instrumentation were preferred.
Authors: Domagoj Coric; Raphael R Roybal; Mark Grubb; Vincent Rossi; Alex K Yu; Isaac R Swink; Jason Long; Boyle C Cheng; Jason A Inzana Journal: Int J Spine Surg Date: 2020-10-29