Radiographic and functional evaluation of the iliac bone graft in the treatment of adolescent idiopathic scoliosis

Abstract

This study aimed to assess the impact of the use of an additional iliac bone graft on functional and radiographic results after thoracic spine arthrodesis with pedicle screws in patients with adolescent idiopathic scoliosis. Participants were divided into two groups: a control group that received only local bone (n=19) and a second group that, in addition to this procedure, received an iliac graft (n=22). The evaluations were performed on preoperative, immediate postoperative, and last follow-up (mean 29.7 months; minimum 12 months). Radiographic evaluations included the loss of correction and the presence of nonunion. The functional outcome was evaluated using the Scoliosis Research Society-30 questionnaire. Surgical complications and the presence of iliac donor site pain were also described. There were no significant differences between groups in the pseudoarthrosis rate, loss of correction over time, and quality of life. We concluded that the addition of bone graft from the iliac yielded no benefit in terms of the fusion rate and functional outcomes. The appropriate facetectomy, bed preparation, and filling with a local bone graft must be adequate to achieve an adequate fusion on surgical treatment of adolescent idiopathic scoliosis.

The clinical use of the enriched bone marrow obtained by selective cell retention technology in treating adolescent idiopathic scoliosis

“…As the established criteria for possible pseudarthrosis, all patients were considered to achieve complete fusion at final visit with a favourable maintenance of curve correction. The incidence of pseudarthrosis was similar to that of autologous bone grafting and lower than that of allografting, which was described previously [ 26 , 27 ]. As with deformity correction, although rigid internal fixation ensures initial stability, the maintenance of corrective effect relies on the definite fusion of the fixed segments.…”

“…Previously, Franzin et al. [ 26 ] compared the functional and radiographic results in patients receiving iliac bone grafts or not receiving iliac bone grafts and reported that the correction loss in the group of iliac bone grafts was 5.9% (nearly 3–4°). Knapp et al.…”

Local Prophylactic Teicoplanin Effect on Spinal Fusion Surgery: A Comparative Retrospective Study

“…Both autogenous or allogeneic biological grafts and synthetic grafts have been used for this purpose and their effectiveness and disadvantages have been debated in several studies. [52][53][54] Harvesting grafts from the iliac crest may cause several morbidities such as increased bleeding, prolonged surgery time, neurological damage, gait disturbance, fractures, painful scars, and cosmetic defects. 52 The most commonly encountered complication is chronic donor site pain with a prevalence reaching 31%.…”

“…[52][53][54] Harvesting grafts from the iliac crest may cause several morbidities such as increased bleeding, prolonged surgery time, neurological damage, gait disturbance, fractures, painful scars, and cosmetic defects. 52 The most commonly encountered complication is chronic donor site pain with a prevalence reaching 31%. 55 Removal of the spinous processes may cause cosmetic defects.…”