Autologous bone grafting in staged scoliosis surgery. The patient as bone bank.
METHODS
A prospective clinical study in which autologous rib graft, harvested during the thoracotomy in staged scoliosis correction, is stored within the patient for use during the second stage (posterior intrumentation and fusion).


OBJECTIVE
To determine whether the bone stored by this technique is biologically viable and microbiologically safe.


BACKGROUND
To the authors' knowledge, this method of storage of bone has never been described previously.


METHODS
During the first operation, the excised rib was divided into 3-5 cm fragments and stored in a sub-muscular plane adjacent to the posterior elements of the spine before closure. The graft was then retrieved at the second stage. Samples were sent for histologic and microbiologic examination before implantation.


RESULTS
On histologic examination, more than 50% of the osteocytes retained their basophilic staining, indicating that they were viable. In addition, osteoclastic activity was notably absent. There was no significant bacterial contamination of the samples. Clinically, all patients achieved satisfactory bone fusion.


CONCLUSIONS
Homeostatic equilibrium in humans provides the ideal environment in which bone graft can be stored. There is no increased risk of infection, and the osteogenic potential of the graft is retained.
Chugh
S
S
Department of Spinal Surgery, Royal Orthopaedic Hospital NHS Trust, Northfield, Birmingham, United Kingdom.
Marks
D S
DS
Mangham
D C
DC
Thompson
A G
AG
D016025:Bone Transplantation; D002470:Cell Survival; D006085:Graft Survival; D006801:Humans; D009926:Organ Preservation / Q000379:methods; D010011:Osteocytes / Q000166:cytology; D011446:Prospective Studies; D012272:Ribs / Q000382:microbiology / Q000473:pathology / Q000601:surgery / Q000637:transplantation*; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D014182:Transplantation, Autologous