Fusion outcomes of structural bone allograft in cervical and lumbar spine surgery: analysis of 147 patients over a decade of follow-up.

Background: There has been a global increase in spinal fusion surgeries, driving the need for improved graft materials. Human structural allografts from tissue banks provide a safe, cost-effective and efficient alternative, circumventing donor site issues and reducing operating time. This study retrospectively analyses the long-term follow-up of human structural grafts used in various spinal fusion surgeries. The analysis aims to highlight that structural bone grafts are a viable option for spinal fusion.

Methods: The study included 147 patients over 18 years old who were treated for cervical and lumbar spinal degenerative, traumatic or oncologic conditions at a single hospital from January 2006 to December 2016. Clinical and radiological follow-up was conducted until December 2023. Human structural bone grafts, sourced from cadaver donors and provided by a single tissue bank, were used in all cases.

Results: A total of 98 patients underwent cervical surgery. Among these, 77.6% received bone grafting due to cervical spine fracture luxation, 21.4% for severe degenerative conditions, and 1.0% for corpectomy consequent to tumour metastasis. The mean follow-up was 155.0±35.7 months, with no subsidence documented. A total of 49 patients underwent lumbar surgery, with 95.9% receiving human bone grafting for lumbar spine fracture luxation and the remaining patients for multiple myeloma and degenerative conditions. The mean overall follow-up was 144.7±38.9 months, with only 1 case of subsidence registered in this group. In 98.9% of cervical and 97.9% of lumbar patients, satisfactory fusion was achieved and maintained over the years.

Conclusions: Homologous structural bone grafting remains an excellent option for spinal fusion in traumatic and degenerative conditions or as a valuable option in spinal revision surgeries and in cases where the use of cages is not feasible due to anatomical constraints.