Abstract
Twenty-seven patients with neurological deficit due to burst fractures were treated with fresh frozen allografts following anterior spinal decompression. Their mean age was 28 years. In 19 patients the injury was due to motor vehicle accidents and in five to falls. The mean preoperative kyphosis was 19° (4° to 33°). Three patients with laminae fractures, which resulted in entrapment of the dura, underwent posterior decompression and transpedicular fixation before anterior decompression. Corpectomy was performed in all patients. An appropriate length of femoral allograft was positioned by interference fit and the spine was stabilised with an anterior rod screw construct in 21 patients.
The follow-up ranged from 29 to 72 months. Bridwell grade-I fusion was seen in 23 patients at two years. Subsequent follow-up revealed no fracture, resorption or collapse. The mean neurological recovery was 1.4 Frankel grades. Nine patients (37%) made a complete recovery but in four (16%) there was no improvement. The mean postoperative kyphosis was 9° and at two years the mean loss of correction was 3°. One patient presented with a psoas abscess at two-year follow-up. At surgery the graft was partially resorbed but was stable. At six-year follow-up the patient was asymptomatic with a grade-II fusion.
The use of allografts saves considerable time in surgery and avoids potential donor site morbidity. They are versatile and are easily available.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.
