¿Es el autoinjerto del campo quirúrgico suficiente para la obtención de una buena artrodesis en paciente con escoliosis idiopática del adolescente?

Abstract

ObjectiveThe purpose of this study was to compare postoperative clinical and radiological results in adolescent idiopathic scoliosis curves treated by posterior arthrodesis using autogenous bone graft from iliac crest (CI) versus only local autograft bone (HL). Patients and methodsA retrospective matched cohort study was conducted on 73 patients (CI n=37 and HL n=36) diagnosed with adolescent idiopathic scoliosis and treated surgically by posterior arthrodesis. The mean post-operative follow-up was 126 months in the CI group vs. 66 months in the HL group. The radiographic data collected consisted of preoperative, postoperative, and final follow-up antero-posterior and lateral full-length radiographs. Loss of correction and quality of arthrodesis were evaluated by comparing the scores obtained from the Spanish version of the SRS-22 questionnaire. ResultsThere were significant differences in the post-operative results as regards the correction of the Cobb angle of the main curve (HL 61±15% vs. CI 51±14%, P<.004), however a greater loss of correction was found in the local bone group (CI 4.5±7.3° vs. HL 8.5±6.3°, P=.02). There were no significant differences as regards the correction of the Cobb angle of the main curve at the end of follow-up. There were no clinical differences between the two groups in the SRS-22 scores. ConclusionAt 5 years of follow-up, there was a statistically significant greater loss of radiographic correction at the end of final follow-up in the local bone graft group. However clinical differences were not observed as regards the SRS-22 scores.