Study design: This was a prospective study of 24 adult patients with kyphosis or anterior column spinal defects treated with anterior fresh frozen allograft for anterior column defects and posterior instrumentation and autogenous grafting.
Objectives: The objectives of the study were to assess the effectiveness of the anterior allograft in maintaining sagittal correction and to assess anterior incorporation.
Summary of background data: Twenty-four patients were followed for a minimum of 2 years (range, 2 + 0-5 + 4 years).
Methods: Upright radiographs were analyzed before surgery, immediately after surgery, and at the final follow-up examination to assess success of anterior fusion and maintenance of correction. A strict four-point grading system was used. Two independent observers analyzed the radiographic results.
Results: Only two patients showed some collapse of their anterior allograft. The other 22 patients maintained correction, attaining a Grade I or Grade II fusion. Semiconstrained instrumentation ws used posteriorly in the two patients who had graft collapse.
Conclusions: Anterior structural allograft worked effectively to maintain correction of kyphosis if combined with posterior instrumentation and autogenous grafting. Rigid forms of posterior instrumentation were preferred.