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Radiographic and functional evaluation of the iliac bone graft in the treatment of adolescent idiopathic scoliosis

Franzin, Fernando J.a; Gotfryd, Alberto O.a; Neto, Nicola J.C.a; Poletto, Patricia R.b; Milani, Carloc; Mattar, Thiagoc; Rodrigues, Luciano M.R.c

Journal of Pediatric Orthopaedics B: July 2014 - Volume 23 - Issue 4 - p 307–311
doi: 10.1097/BPB.0000000000000037
Spine

This study aimed to assess the impact of the use of an additional iliac bone graft on functional and radiographic results after thoracic spine arthrodesis with pedicle screws in patients with adolescent idiopathic scoliosis. Participants were divided into two groups: a control group that received only local bone (n=19) and a second group that, in addition to this procedure, received an iliac graft (n=22). The evaluations were performed on preoperative, immediate postoperative, and last follow-up (mean 29.7 months; minimum 12 months). Radiographic evaluations included the loss of correction and the presence of nonunion. The functional outcome was evaluated using the Scoliosis Research Society-30 questionnaire. Surgical complications and the presence of iliac donor site pain were also described. There were no significant differences between groups in the pseudoarthrosis rate, loss of correction over time, and quality of life. We concluded that the addition of bone graft from the iliac yielded no benefit in terms of the fusion rate and functional outcomes. The appropriate facetectomy, bed preparation, and filling with a local bone graft must be adequate to achieve an adequate fusion on surgical treatment of adolescent idiopathic scoliosis.

aDepartment of Orthopaedics and Traumatology, Santa Casa da Misericórdia de Santos

bDepartment of Physical Therapy, Universidade Federal de São Paulo (UNIFESP), São Paulo

cDepartment of Orthopaedics Surgery, Faculdade de Medicina do ABC, Santos André, Brazil

Correspondence to Carlo Milani, PhD, Department of Orthopaedics Surgery, Faculdade de Medicina do ABC, Rua Principe de Gales, 821, Santo André (SP) 09060-650, Brazil Tel: +55 11 4083 6700; fax: +55 11 4083 6852; e-mail: carlom@uol.com.br

© 2014 by Lippincott Williams & Wilkins, Inc.