title: Surgical treatment of scoliosis using allograft bone from a regional bone bank.
abstract: BACKGROUND
  Routine spinal fusion techniques have involved removal of all soft tissues and articular facets, decortication of all posterior elements, and application of bone graft to the fusion area. Bone grafting has been performed mainly using the patient's own bone (autograft bone), most commonly from the iliac crest. The use of autograft bone is accompanied by complications or problems because of harvesting and donor-site morbidity. Several studies have already reported the use of allograft bone in scoliosis surgery. However, these studies are small series with short-term follow-up.
  
  
  METHODS
  Twenty-two patients with scoliosis who underwent posterior spinal fusion and pedicle-screw-alone fixation using banked allograft bone obtained from the regional bone bank in Japan were analyzed. The average age at surgery was 13 years 5 months. The average follow-up was 2 years 7 months, and the average age at the last follow-up was 15 years 6 months. Scoliosis curves were divided into two groups (single curve group and double curve group).
  
  
  RESULTS
  For the single curve group, the average preoperative coronal curve measured 78° (48°-85°) and the postoperative curve measured 22° (8°-35°), with no loss of correction at the last follow-up. For the double curve group, the average preoperative thoracic curve measured 64° (48°-85°) and the lumbar curve measured 42° (38°-60°). The average postoperative thoracic curve measured 12° (8°-34°) and lumbar curve measured 15° (8°-32°), with no significant loss of correction at the last follow-up. No patients had clinical complaints in the region of surgery at 9 months after surgery and thereafter. There were no complications including loss of correction, nonunion, infection and instrumentation failure. At the last follow-up, patients/parents were interviewed and asked to complete an outcome satisfaction questionnaire. They were asked to rate the outcome as very satisfactory, satisfactory, neither satisfactory nor unsatisfactory, unsatisfactory, or very unsatisfactory. Seventeen patients (77%) were very satisfied, four patients (17%) were satisfied, and one patient (6%) was neither satisfied nor unsatisfied. Autograft bone and banked allograft bone appear to yield comparable results and clinical outcomes.
  
  
  CONCLUSIONS
  However, in Japan, various expenses accrue to supply a safe and premium quality of banked allograft bone. Financial issue must be resolved as soon as possible.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan. mtakaso@kitasato-u.ac.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Takaso
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Nakazawa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Imura
authors.forename: Masaki
authors.initials: M
authors.lastname: Ueno
authors.forename: Wataru
authors.initials: W
authors.lastname: Saito
authors.forename: Ryousuke
authors.initials: R
authors.lastname: Shintani
authors.forename: Kensuke
authors.initials: K
authors.lastname: Fukushima
authors.forename: Masahiro
authors.initials: M
authors.lastname: Toyama
authors.forename: Kouji
authors.initials: K
authors.lastname: Sukegawa
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Okada
authors.forename: Michinari
authors.initials: M
authors.lastname: Fukuda
mesh_terms: D000293:Adolescent; D016025:Bone Transplantation; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion; D014015:Tissue Banks