Local autograft bone in the surgical management of adolescent idiopathic scoliosis.

Methods: A retrospective study. Objective: The study was performed to determine the efficacy of local autograft bone in idiopathic scoliosis surgery on patients who had had spinal fusion with a Cotrel Dubousset device between 1990 and 1995.

Background: Studies seemed to promote the used of autograft bone (iliac crest, ribs), allograft bone, or bone graft substitutes in adolescent idiopathic surgery. To the authors' knowledge, there have been no previous articles concerning in situ local auto graft bone in idiopathic scoliosis surgery in the literature.

Methods: Twenty five patients with idiopathic scoliosis, aged 11 to 18 years, were treated by posterior correction and arthrodesis using Cotrel-Dubousset instrumentation. Posterior spinal fusion was performed using only local bone grafts. The patients were reviewed with a mean postoperative observation time of 6 years (5-9). The results were assessed clinically and radiographically.

Results: Preoperative single curves averaged 56 degrees in the frontal plane with an average postoperative curve of 16 degrees. Preoperative double curves in the frontal plane averaged 55 degrees in thoracic curves and 49 degrees in lumbar curves with an average postoperative curve of 18 degrees in thoracic and 13 degrees in lumbar. At the final follow-up, there was no losing in the correction. There was no pseudarthrosis clinically or radiographically.

Conclusions: In adolescent idiopathic scoliosis surgery, local autograft bone allows to avoid the necessity of any over graft.