Abstract
Introduction
Spine surgery allografts show a lower fusion rate than autografts in posterior arthrodesis, but they demonstrated their full effect in reconstructions of the anterior column, probably for biomechanical reasons (load compression forces on the graft).
Patients and Methods
We report our experience in 13 patients affected by spine tumors and treated with total vertebrectomy (12 patients one level, 2 patients two levels, and 1 patient three levels) and reconstruction with massive bone bank graft (femoral diaphysis rings) filled in 2 cases with acrylic cement and in 12 cases with fresh iliac autografts. The demographic was five metastasis, three hemangioendotheliomas, one chordoma, two germ cell tumors, and one multiple endocrine neoplasia. The follow-up ranges from 192 to 36 months, with a mean of 97, the mean age 49 years, the levels treated from D1 to L5, the length of the vertebral resection ranges from 30 to 75 mm. All patients were monitored with X-ray standard at 3, 6, 9, and 12 months after surgery, spiral CT, and standard X-rays on an annual basis from the first year.
Results
X-ray revealed excellent stability with complete interbody fusion in all patients after 12 to 15 months from surgery. We have found lines of radiolucency in 15% of patients at the proximal and distal screws but without any associated clinical sign.
Discussion
Although the small series, the mean follow-up of 8.1 years allows us to say that this technique could be useful in clinical treatment of complex diseases of the spine where a circumferential reconstruction is required, achieving to a final, complete, and stable interbody fusion.