Healos graft carrier with bone marrow aspirate instead of allograft as adjunct to local autograft for posterolateral fusion in degenerative lumbar scoliosis: a minimum 2-year follow-up study.
OBJECTIVE
The objective of this study was to examine the efficacy and safety of Healos graft carrier with bone marrow aspirate and local autograft compared with the results of allograft in patients with lumbar degenerative scoliosis undergoing posterolateral fusion.


METHODS
Twenty-eight patients with degenerative scoliosis underwent posterolateral instrumented fusion and decompression. Patients were grouped according to the graft used. Group A consisted of 12 cases in which the authors used a Healos graft carrier, bone marrow aspirate, and local autograft, and Group B consisted of 16 cases in which the authors used cancellous allograft and local autograft. Patients were followed for a minimum of 2 years postoperatively in terms of pain (visual analog scale), function (Oswestry Disability Index), curve magnitude (Cobb angle), and fusion status (plain and dynamic radiographs). The 2 groups did not differ statistically significantly (p > 0.05) in age, sex, smoking habits, magnitude of preoperative visual analog scale score, Oswestry Disability Index score, Cobb angle, or number of levels requiring decompression and fusion.


RESULTS
The groups had similar (p > 0.05) results in terms of pain, function, curve progression, and fusion rates at the 2-year follow-up examination. Radiographic fusion was achieved in all but 2 cases, 1 in each group, in which the patients were asymptomatic. Patients in the allograft group (Group B) showed evidence of fusion earlier than in the Healos group (p < 0.05). No toxicity from Healos graft was recorded.


CONCLUSIONS
The combination of Healos hydroxyapatite sponge and bone marrow aspirate plus local allograft had significantly slower fusion rates but equal clinical outcomes compared with cancellous allograft plus local autograft when used for posterolateral fusion in patients with degenerative lumbar scoliosis.
Ploumis
Avraam
A
Orthopaedic Department, Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA. aploumis@cc.uoi.gr
Albert
Todd J
TJ
Brown
Zoe
Z
Mehbod
Amir A
AA
Transfeldt
Ensor E
EE
D000368:Aged; D001672:Biocompatible Materials / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D004185:Disability Evaluation; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D015503:Surgical Sponges; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D001672:Biocompatible Materials; D017886:Durapatite