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Treating Congenital Spine Deformities with Freeze-Dried Bone Graft
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Posted on: 09/20/2007
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This is the first report of spinal fusion in children with congenital scoliosis using freeze-dried allograft bone chips. The results were very favorable using allograft bone as a substitute for graft material usually taken from the iliac crest.
Scoliosis is a curvature of the spine. It can occur for unknown reasons, or it may be hereditary. Children who are born with scoliosis have the congenital type. Congenital scoliosis is often severe enough to require surgery to fuse the spine in place.
Metal rods and screws are used to hold the spine upright until the fusion occurs. Bone chips are also used to complete the fusion. Allograft material comes from a bone bank. It is used as a substitute for bone that is usually taken from the patient.
Bone harvested from the patient is called an autograft. Autografts can be painful and leave a scar. With allografts, the operation is shorter. There's a larger supply of allograft bone available. And there's no pain or scar to deal with.
But there are some potential risks using allografts. There has been some fear that viruses such as HIV could be transferred through the graft. Infection is another possible problem. And sometimes the bone doesn't generate new bone growth as it's supposed to. Instead the fusion is unsuccessful.
In this study, the authors report a very successful outcome. They used freeze-dried bone allograft in a series of children who had congenital spinal deformities. There was a very low rate of fusion failure. Almost all of the children had a successful outcome.
The authors believe that careful surgical technique in a young population make the use of allograft bone a good option. Surgeons should consider allograft when fusing the spine in children with congenital scoliosis.
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References:
Daniel Hedequist, MD, et al. The Use of Allograft as a Bone Graft Substitute in Patients with Congenital Spine Deformities. In Journal of Pediatric Orthopaedics. September 2007. Vol. 27. No. 6. Pp. 686-689.
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