Interbody Fusion using Iliac Crest Allograft in Global Spinal Fusion

Kim, Eung Ha; Suh, Kwang Sik; Cho, Duck yun

Abstract

PURPOSE
To analyze the efficacy of iliac tricortical allograft (Tutoplast (r) ) as an anterior load sharing construct in global fusion consisting of interbody fusion, transpedicular screw fixation and posterolateral fusion. MATERIALS METHODS: We followed up 40 levels in 27 patients who had undergone interbody fusion using iliac tricortical allograft (Tutoplast (r) ) and added transpedicular screw fixation and poterolateral fusion from Dec. 1995 to Dec. 1996. They were followed up for more than 2 years. The disease entities included 11 patients with spondylolisthesis, 8 patients with spinal stenosis with lumbar intervertebral discs herniation, 6 patients with degenerative lumbar kyphoscoliosis and 2 patients with pseudoarthrosis. Anterior interbody fusion was performed in 11 cases and posterior lumbar interbody fusion in 16 cases.
RESULTS
The radiological union rate of interbody fusion was 90% (36/40) , and collapsed union was 7.5% (3/40) ranging from 11% to 28% collapses of initial graft height. The non-union occurred at level 1, which showed radiolucent line on host-graft interface but did not reveal instability on stress views. The radiologic union rate of the posterolateral fusion was 100%. Complications such as metal failure and infection were not noted. Satisfactory clinical results were 88.9%.
CONCLUSION
Iliac tricortical allograft was a good substitute for an anterior load sharing construct in interbody fusion combined with transpedicular screw fixation and posterolateral fusion.