Fresh-frozen femoral head allograft as lumbar interbody graft material allows high fusion rate without subsidence

SummaryBackgroundCircumferential lumbar spinal fusion is widely used to increase fusion rate, but little data is available using fresh-frozen femoral head allograft (FFFHA) as a structural interbody graft alternative.HypothesisCircumferential lumbar arthrodesis using FFFHA as interbody graft material could be an alternative to achieve interbody fusion without graft subsidence.MethodsA retrospective review of 47 patients (56 levels) treated with lumbar circumferential fusion using FFFHA as interbody material. Consolidation was independently assessed by the two authors using a 3-type scale; interbody bone graft subsidence was also evaluated.ResultsForty-four of the 47 patients (93.6%), and 53 of the 56 levels (94.6%) obtained consolidation, without differences between smokers and nonsmokers. Three levels (in three patients) did not fuse; one of them (2.1%) required revision. No patient presented graft dislodgment, signs of infection or graft subsidence at the last follow-up.DiscussionFFFHA use as lumbar interbody graft in circumferential arthrodesis exhibited a 94% fusion rate, without graft subsidence. FFFHA may be considered a valid alternative to achieve interbody fusion.Level of evidenceLevel IV. Retrospective study.