A Prospective Analysis of Autograft Versus Allograft in Posterolateral Lumbar Fusion in the Same Patient

Abstract

One hundred forty four patients who underwent lumbar spine fusions had autografts placed on one side as a control and on the opposite side one of the following types of graft material was placed: iliac autograft, demineralized cancellous chips, demineralized cortical powder, demineralized cortical powder mixed with autograft, or mineralized cancellous chips. Alar anteroposterior and lateral postoperative radiographs were reviewed by three independent observers and graded for quality of fusion mass bilaterally. The follow-up was 14 to 27 months. This study evaluated the efficacy of various types of ethylene oxide-sterilized allograft bone used for spine fusions and compared them with autograft iliac bone in the same patient. Previous studies comparing autograft with allograft showed poorer fusion rates with allograft with posterior fusions. Most of the previous studies included smaller numbers of patients. No previous studies compared ethylene oxide-treated allograft with autograft. An analysis of the radiographs at a minimum of 1 year postoperatively revealed significantly lower values when allograft alone or in combination with autograft was used in comparison to autograft alone. Ethylene oxide-treated allograft is inferior to autograft and should not be used for posterior lumbar fusions.