The authors present case histories relating to experience gained over 18 months of using deantigenic osseous grafts together with platelet growth factor for posterior spine arthrodesis. The spinal column was the last section of the skeleton to recover from the use of this kind of bone graft to promote spinal fusion. This is due to the negative experience encountered during the proposals bought forward during the 1960s and 1970s by French orthopaedic surgeons who used heterologous lyophilised bone for long vertebral arthrodesis.

The high incidence of pseudoarthrosis developed as a result of difficulties in absorption of the skeletal implant, which, in order to ensure sufficient mechanical resistance, should have been thicker (8 mm). Therefore it could not be assimilated. This then resulted in relying only on external protection (plastered brace) to provide the necessary rigidity during the process of fusion.

The beginning of stable synthesis obtained with transpeduncular fixation and double instrumentation as used in the Cotrel Doubousset technique and methods derived from it made it possible to maintain primary stability over time, therefore positively influencing the process of consolidation. This is why the practice of exclusively using osseous derivations has grown only in the past few years in vertebral surgery, preferring to implant small chips which can be assimilated much easier and to avoid having to search for mechanically resistant areas for bone replacement.

In conclusion, the use of heterologous bone grafts in the vertebral column represents a situation similar to that in other mobile osseous areas, in which the immobilisation depends on the use of a mechanical instrument (when it concerns short arthrodesis 2–3 segments). In the case of long spinal fusion such as in correcting vertebral deformity (scoliosis and kyphosis), the problem is more complicated, even though today’s new biological tools (large extension of the bed of arthrodesis) make this possible and offer the advantages of the lack of problems at the donor site. In these cases it is particularly suitable to routinely combine heterologous bone replacement with growth factors (osteoinductive bone proteins) for treatment, which according to our preliminary results should notably shorten the period of assimilation and the fusion healing.

In this work we report our experience, which began in 1981, with 200 patients in the correction of complex deformities (rotational and angular) of the inferior limbs by using the IIizarov method. In our case histories, we demonstrate the advantages of treatment of complex deformities using correction techniques such as epiphysiodesis operations performed in open surgery access or by using percutaneous stapling or osteotomic corrections, which in our experience are only indicated in single plane lower limb deformities.

On the other hand, we demonstrate the complete validity of the IIizarov method in the progressive correction of the multi-planar deformities. Such methods allow progressive correction of the deformities in three different spatial planes, resulting, in addition to the possible improvement in the angular defects, in the simultaneous correction of the torsional defects.

The critical analysis of our experience also demonstrates the possible complications inherent in the IIizarov method and which have been subdivided into further and greater complications, such as in the acute treatment of serious deformities (joint stiffness, nerve paralysis, and deep pin track infection) and in minor complications (superficial pin track infection).